You are evaluating a patient with a penetrating chest injury. The physical exam of the chest reveals decreased chest excursion with a dull percussion note and decreased breath sounds on the right hemithorax. An upright chest radiograph has been ordered to confirm the clinical diagnosis of a hemothorax. The report reveals no obliteration of the right costophrenic angle. How would you explain this radiographic finding?

Question

Quizplus · Accepted Answer

The absence of obliteration of the costophrenic angle on an upright chest x-ray suggests that the amount of blood in the pleural space is likely less than 400 to 500 mL, as larger volumes would typically cause blunting of the angle.

You Are Evaluating a Patient with a Penetrating Chest Injury