The Chest X-Ray Database
The Chest X-Ray Database
This radiograph shows a left anterior shoulder dislocation in a trauma patient. The humeral head projects inferior and medial to the glenoid. No associated fracture is evident, though dedicated shoulder imaging should be performed to evaluate for Bankart and Hill-Sachs lesions. The patient’s hair is in a ponytail with an elastic band which can be seen projecting over the cervical spine and should not be confused with a foreign body. The remainder of the exam is unremarkable.
This radiograph shows a skin fold projecting over the right hemithorax that could be easily mistaken for a pneumothorax. Skin folds are frequently identified as such because they cross anatomic boundaries such as the mediastinum or lateral chest wall. The lack of clinical symptoms such as shortness of breath can be reassuring, but not definitive. In this case, the most definitive imaging finding that distinguishes the skin fold from a pneumothorax is the minor fissure which remains intact across the pseudo-pleural separation. A repeat chest radiograph was obtained with instruction to the technologist to smooth the patient’s skin and clothing prior to acquisition and the finding was no longer present. A left lateral decubitus radiograph would have also been an appropriate next step.