Presentation
Mild left sided chest pain for the last few weeks.
Patient Data
Plain radiograph of the chest reveals large left sided pneumothorax with hypertransradiancy and mediastinal shift. No significant tracheal deviation is noted. Note is also made of bilateral accessory cervical ribs.
B-Mode Ultrasound of the chest on the left side reveals the famous barcode sign of pneumothorax with multiple parallel lines. Rib shadows are seen on either side of the intercostal space.
For comparison, on the ride side of the chest B-Mode Ultrasound scan reveals normal intact respiratory movements. The famous sea-shore sign was seen.
Case Discussion
Pneumothorax occurs when air enters the pleural space, leading to lung collapse. In radiographs, it typically appears as a visible "white line" at the lung periphery, the visceral pleural line with absent lung markings beyond it. This creates a sharp demarcation between the collapsed lung and the pneumothorax.
The "seashore sign" refers to the sand-like appearance of the pleural line on ultrasound in a normal aerated lung. In pneumothorax, this characteristic seashore sign is lost. Instead, the ultrasound image shows parallel hyperechoic lines without the normal undulating pattern which is referred to as the "barcode sign." This change in appearance is due to the absence of lung sliding and the presence of air in the pleural space which disrupts the normal pleural line dynamics. Recognizing the barcode sign is important for diagnosing pneumothorax using ultrasound imaging.
Unable to process the form. Check for errors and try again.