What does chest X-ray show in a tension pneumothorax?

What does chest X-ray show in a tension pneumothorax?

• A. Lack of lung vascular markings at the periphery
• B. Normal lung markings
• C. Cardiomegaly
• D. Bilateral effusions

Answer: (A)

In a tension pneumothorax, air accumulates under pressure in the pleural space and collapses the affected lung. On the chest X-ray, the hallmark is a pleural line with no lung markings beyond that line—the air in the pleural space makes the periphery appear lucent and devoid of vascular markings. You may also see the mediastinum shifted away from the affected side due to the pressure, and a depressed hemidiaphragm. The other options don’t fit because normal lung markings would mean no pneumothorax, cardiomegaly implies an enlarged heart, and bilateral effusions show fluid with blunted costophrenic angles.

In a tension pneumothorax, air accumulates under pressure in the pleural space and collapses the affected lung. On the chest X-ray, the hallmark is a pleural line with no lung markings beyond that line—the air in the pleural space makes the periphery appear lucent and devoid of vascular markings. You may also see the mediastinum shifted away from the affected side due to the pressure, and a depressed hemidiaphragm. The other options don’t fit because normal lung markings would mean no pneumothorax, cardiomegaly implies an enlarged heart, and bilateral effusions show fluid with blunted costophrenic angles.