Michael P. D'Alessandro, M.D.
Peer Review Status: Internally Peer Reviewed
A pneumothorax is difficult to visualize on a supine film. The most common place to see one is in the medial basal and basilar portions of the lung. The best film to obtain to diagnose a pneumothorax is a decubitus film with the suspicious side up.
A pneumopericardium may be difficult to distinguish from a pneumomediastinum as both may have a "continuous diaphragm sign." In a pneumopericardium, air will never dissect above the level of the main pulmonary artery, which is the superior extent of the pericardium. In a pneumomediastinum, air can dissect all the way up the mediastinum into the neck.
See References Chapter.
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