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Subpulmonic hemothorax from rib fracture

Imaging findings

Chest radiograph shows a large left-sided subpulmonic opacity that simulates elevated diaphragm. CT confirms a displaced lower rib fracture and a large subpulmonic hemothorax.

Key takeaways

Subpulmonic pleural fluid collects between the lung base and diaphragm, mimicking diaphragm elevation on upright radiographs. CT is useful to confirm fluid, identify rib fractures, and rule out diaphragmatic rupture.

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