Is that a lung edge? A case of simulated pneumothorax and survey of emergency physicians?? awareness of this phenomenon

Abstract

Our results show that almost half of our colleagues would have carried out tube thoracostomy when no pneumothorax was actually present. In a situation where a pneumothorax is a clinical possibility we would recommend either temporarily removing the oxygen mask if clinically stable, or fixing the reservoir bag outwith the field of the CXR by means of adhesive tape to avoid any misinterpretation of this 'mask sign'.

A case of paediatric simulated pneumothorax: Figure 1

“…Simulated pneumothorax has previously been shown to be poorly recognised in an adult population,1 and in view of the potential for serious harm, we contend that the attending physician should always take note of objects likely to cause an artefact on the radiograph before interpreting the image. This is especially true in paediatric patients, in whom the physical and mental harm caused by any error, such as intercostal drain insertion, is likely to be significant.…”