Chest X Ray Medical Question

Question

A patient is brought to the emergency room following a motor vehicle accident. He was not wearing a seat belt, and has considerable soft-tissue bruising about his anterior chest, where he apparently hit the steering wheel. He is dyspneic, and has a slight left tracheal shift (trachea is now left to midline). Within an appropriately sequenced X-ray examination, the RRT might expect to find etiology evidence of:

A. A significant radiopaque finding on the right side

B. A significant radiopaque finding on the left side

C. A significant radiolucent finding on the right side

D. A significant radiolucent finding on the left side

Is the answer C?

Answer 1

Based on the clinical findings provided by the question the patient most likely has a tension pneumothorax. The radiographic features of a tension pneumothorax include contralateral shift of the mediastinum, depression of the hemidiaphragm, and ipsilateral increased intercostal spaces. Since the trachea is deviated towards the left this indicates that the pneumothorax is on the right side, which will appear radiolucent on a chest x-ray due to the less dense peripheral space. Thus the answer is C.