Imaging Case of the Week 547 Answer

Deep Sulcus Sign.

There is a supine pneumothorax on the right as evidenced by a deep sulcus sign. Other findings are – ETT which is abutting the right main bronchus (needs to be pulled back a bit), a right sided subclavian line & a right pleural line visible all the way up to the apex.

Deep sulcus sign is said to be present on a supine chest x-ray when the costophrenic angle is radiolucent and dips into the hypochondrium. It indicates the presence of a pneumothorax. It may be the only sign of abnormal pleural air.

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