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CXR - left sided pneumothorax and surgical emphysema

In this Chest X-Ray we can identify a left sided pneumothorax - there is absence of lung markings in the periphery and we can also see a shadow which outlines the edge of the lung. A pneumothorax is caused when air enters the potential space between the viceral and parietal pleura and causes the lung to collapse down under the pressure of it's elsatic recoil. In this case it is likely that the pneumothorax has been caused by trauma as we can see air in the soft tissues on the left side (surgical emphysema - clinically feels like bubble wrap). A pneumothorax can be a life threatening condition. The patient presents in respiratory distress with decreased expansion on the affected side. There will be hyperresonance to percussion on that side but absent breath sounds. The emergency treatment is decompression with a large bore cannula in the 2nd intercostal space mid-clavicular line followed by insertion a chest drain in the 5th intercostal space mid-axilllary line  
Rhys Clement
about 10 years ago
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Pleural effusion x-ray (left-sided)

This PA Chest X-Ray demonstrates a left sided pleural effusion. In this condition fluid collects between the parietal and visceral pleura and appears as a shadowy fluid level on the X-Ray with obliteration of the costophrenic angles. If you were to examine this patient they might be in respiratory distress from reduced oxygen uptake (so have low sats, high resp rate, possible cyanosis and accessory muscle useage) - they may have reduced chest expansion on the affected side and it would be stony dull to percussion. Fluid transmits sound poorly so breath sounds would be decreased as would vocal resonance/fremitus. Someone with consolidation may have very similar clinical findings but the underlying area of lung is almost solid due to pus from the infective process - as sounds travel well through solids they would have increased vocal fremitus which is how you can clinically differentiate between the two conditions. Clinical examination and understanding of conditions is paramount to practice effective medicine. Before you recieved this X-Ray you should be able to diagnose the condition and use the X-Ray to confirm your suspicions.  
Rhys Clement
about 10 years ago

Traumatic eye injury hypothetical case presentaion

Ophthalmology Hypothetical Case Presentation & Management Ben Savage, Adam Pill Jemma Slingsby, Victoria Tuck Clement Guineberteau  
Dr Ben Savage
about 10 years ago

Shoulder Dislocations

Shoulder Dislocations Ben Savage  
Dr Ben Savage
about 10 years ago
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Death verification

Poster to help with death verification  
Martin Wicks
over 10 years ago

Back Pain

A short presentation looking at the epidemiology, pathology and treatment of back pain.  
James Harper
about 11 years ago