A 70-year-old male smoker presents with sudden onset of right-sided pleuritic chest pain and dyspnoea. Chest X-ray shows a thin radiolucent line (visceral pleural line) parallel to the chest wall with no lung markings peripheral to it. Which diagnosis is most likely?
- A Large bulla
- B Pneumothorax ✓
- C Pneumomediastinum
- D Subcutaneous emphysema
Correct answer: B. Pneumothorax
Explanation
A pneumothorax is diagnosed on a PA chest X-ray by a visible visceral pleural line separated from the chest wall by radiolucent air, with absent lung markings beyond it. A large bulla has a concave inner margin, not convex. Pneumomediastinum shows air outlining the heart. Subcutaneous emphysema shows soft-tissue gas, not a pleural line.
Reference: Chest X-ray Made Easy, 5th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.