A 48-year-old man presents with sudden onset pleuritic chest pain and mild dyspnea. Chest X-ray shows a thin, white visceral pleural line with absence of lung markings peripheral to it. Which of the following best describes this finding?

• A Consolidation of the right upper lobe
• B Pulmonary embolism with Hampton hump
• C Pleural effusion
• D Pneumothorax ✓

Explanation

The description of a visceral pleural line with absent lung markings beyond it is the classic radiographic sign of pneumothorax on a plain chest X-ray. Consolidation would show air bronchograms and opacity, not a pleural line with absent markings. Pleural effusion blunts the costophrenic angle and causes a meniscus-shaped opacity. Hampton hump is a wedge-shaped peripheral opacity, not a linear pleural line.

Reference: Grainger & Allison's Diagnostic Radiology, 7th ed.

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