Critical Care Medicine
When a patient is in the supine position, the classic radiographic findings of a pneumothorax may not be present. In this position, the most superior (ie, the highest) portion of the thorax is near the lung bases. Because pneumothorax air rises to the highest location in the chest, the lung bases should be closely scrutinized for the following signs: (1) clear visualization of the diaphragm anteriorly creating a double appearance of the diaphragm; (2) a deep costophrenic angle (deep sulcus sign); (3) an unusually distinct cardiac apex and pericardial fat tags; and (4) increased radiolucency of the upper abdominal quadrants.
- Deep sulcus sign.
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