When are lateral decubitus radiographs indicated for the evaluation of pneumothorax?

Updated: Apr 28, 2020
  • Author: Brian J Daley, MD, MBA, FACS, FCCP, CNSC; Chief Editor: Mary C Mancini, MD, PhD, MMM  more...
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Answer

Confirmation of a suspected pneumothorax that is not readily observed on standard supine anteroposterior (AP) radiograph can be demonstrated by obtaining a lateral decubitus film with the involved hemithorax positioned uppermost (see the images below).

Lateral radiograph demonstrating tension and traum Lateral radiograph demonstrating tension and traumatic pneumothorax.
Lateral radiograph demonstrating tension and traum Lateral radiograph demonstrating tension and traumatic pneumothorax.
Lateral radiograph depicting tension and traumatic Lateral radiograph depicting tension and traumatic pneumothorax.

In neonatal patients, transillumination may reveal an increased transmission of light through the chest on the affected side.


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