CTICasesSkin Fold Artifact Mimicking Pneumothorax
Imaging findings
Chest radiography demonstrates a thick, curvilinear vertical line in the left hemithorax running parallel to the chest wall, positioned adjacent to a true, thin, white visceral pleural line from a real pneumothorax. The skin fold interface is characterized by a gradual increase in opacity (whiteness) leading up to a sharp boundary, followed by an adjacent Mach band of perceived extra blackness hugging the edge. In contrast, the true pneumothorax line is a thin white line with black lung on one side and black pleural air on the other, devoid of a Mach band.
Key takeaways
Skin folds are common radiographic artifacts that can easily mimic a pneumothorax, particularly on portable, supine films of bedridden or post-operative patients. Differentiating a skin fold from a true pneumothorax relies on recognizing that a true pneumothorax presents as a discrete, thin, white visceral pleural line with no lung markings peripheral to it, whereas a skin fold shows an interface of increasing opacity ending in a sharp edge with a physiological Mach band artifact. Understanding these radiographic nuances is critical to avoiding unnecessary and potentially harmful thoracostomy tube placements.
AI-assisted summary — may contain errors. Verify against the source video. Learn more
More from this webinar
- Adult-Onset Cystic FibrosisCongenital
- Allergic Bronchopulmonary AspergillosisInfection
- Diffuse Bronchiolitis (Suspected Later-Onset Cystic Fibrosis)Infection
- Mediastinal Ewing SarcomaNeoplastic
- Pulmonary NocardiosisInfection
- Granulomatous Fibrosing Mediastinitis (Presumed Histoplasmosis)Infection
- Pulmonary Venous InfarctionIatrogenic
- Nitrofurantoin-Induced Organizing PneumoniaILD
See all cases from May 22, 2021 →
Related Artifact cases
- Transplanted Donor Liver with Retained Bullet Fragment
- Migratory Calcified Pleural Bodies from Extrapleural Fat Necrosis
- Acutely Enlarging Thymic Cyst in a Transplant Patient
- Benign Colonic Pneumatosis after Lung Transplant
- Transdiaphragmatic Air via the Foramen of Morgagni (Macklin Phenomenon)
- Lamellar Pleural Effusion from Subpleural Interstitial Edema