Pseudo-pneumothorax - large bulla

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Pseudo-pneumothorax - large bulla

  • There are several mimics of a pneumothorax. Occasionally a patient's skin can form a fold that mimics the lung edge. If you suspect this is the case in a patient without clinical signs of a pneumothorax then you should consider repeating the X-ray.
  • Occasionally a large bulla, such as in this patient, can mimic a pneumothorax.
  • It is essential that you treat these patients with caution. ALWAYS look to see if there is an old X-ray (the cheapest and quickest test in radiology). If appearances have not changed then you know you are dealing with a bulla. If in doubt a CT can be performed following discussion with a radiologist.
  • Do not insert a chest tube if you are in any doubt about the diagnosis on clinical or radiological grounds.