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The Extra-Pleural and Pleural Spaces, including Plombages, Pleural Tumours and the Effects of Asbestos.
Published in Fred W Wright, Radiology of the Chest and Related Conditions, 2022
Giuffre (1984) reviewed the literature and gave the signs of pneumothoraces in supine patients as follows: fairly common (but occasionally mimicked) signs - lower zone lucency, visible anterior costophrenic sulcus, a deep lateral sulcus ('deepsulcussign'), and sharp mediastinal or diaphragmatic contours, anduncommon (but specific) signs - lobulated epicardial fat pads (owing to the lack of air-filled lung pressing on the fat) and inter-lobar air. All these are due to adjacent pleural air accentuating these anatomical borders. He suggested that in difficult cases one should take coned views of a suspicious area, or use an oblique x-ray beam with the patient in expiration as suggested by Galanski et al. (1981) - see Fig. 14.14c.
Multiple choice questions (MCQs)
Published in Tristan Barrett, Nadeem Shaida, Ashley Shaw, Adrian K. Dixon, Radiology for Undergraduate Finals and Foundation Years, 2018
Tristan Barrett, Nadeem Shaida, Ashley Shaw, Adrian K. Dixon
Which of the following are radiographic signs of a simple pneumothorax? Volume loss of the underlying lung.Visible pleural outline.Flattening of the diaphragm on the affected side.Deep sulcus sign.Mediastinal shift away from the affected side.
Radiologic Diagnosis of Pleural Disease
Published in Philip T. Cagle, Timothy C. Allen, Mary Beth Beasley, Diagnostic Pulmonary Pathology, 2008
Brett Burbridge, Marc V. Gosselin
In the supine patient, air will migrate to the anterior chest as the lungs settle posteriorly because of gravity. Contrasted with an upright patient who will likely demonstrate a pneumothorax in the apices, the supine patient should have unusually deep costophrenic angle(s) on the frontal radiograph, termed the “deep sulcus sign” (Fig. 7).
Optimal diagnostic strategies for pleural diseases and identifying high-risk patients
Published in Expert Review of Respiratory Medicine, 2023
D N Addala, P Denniston, A Sundaralingam, N M Rahman
Pneumothorax can be identified on CXR as a visceral line between lung and chest wall and the absence of lung markings beyond. Pneumothorax may be missed in high-risk acutely unwell patients, for example in those who can only tolerate a supine or semi-erect CXR. The deep sulcus sign on supine CXR describes the phenomenon of pleural air collecting in the anterior costophrenic sulcus, with resultant hyperlucency[7]. It is estimated that additional subtle information on CXR, such as the deep sulcus sign, may identify pneumothorax on 24% of previously missed occult pneumothoraces[8].