DOI QR코드

DOI QR Code

Misinterpretation of a skin fold artifact as pneumothorax on the chest x-ray of a trauma patient in Korea: a case report

  • Yoojin Park (Department of Radiology, Gachon University Gil Medical Center, Gachon University College of Medicine) ;
  • Eun Young Kim (Department of Radiology, Gachon University Gil Medical Center, Gachon University College of Medicine) ;
  • Byungchul Yu (Department of Trauma Surgery, Gachon University Gil Medical Center, Gachon University College of Medicine) ;
  • Kunwoo Kim (Department of Thoracic and Cardiovascular Surgery, Gachon University Gil Medical Center, Gachon University College of Medicine)
  • 투고 : 2023.07.27
  • 심사 : 2024.01.18
  • 발행 : 2024.03.31

초록

Misinterpreting radiographic findings can lead to unnecessary interventions and potential patient harm. The urgency required when responding to the compromised health of trauma patients can increase the likelihood of misinterpreting chest x-rays in critical situations. We present the case report of a trauma patient whose skin fold artifacts were mistaken for pneumothorax on a follow-up chest x-ray, resulting in unnecessary chest tube insertion. We hope to help others differentiate between skin folds and pneumothorax on the chest x-rays of trauma patients by considering factors such as location, shape, sharpness, and vascular markings.

키워드

과제정보

This study was supported by a grant from Gachon University Gil Medical Center (No. FRD2021-11).

참고문헌

  1. Lewis BT, Herr KD, Hamlin SA, et al. Imaging manifestations of chest trauma. Radiographics 2021;41:1321-34. https://doi.org/10.1148/rg.2021210042
  2. Mathew RP, Alexander T, Patel V, Low G. Chest radiographs of cardiac devices (part 1): lines, tubes, non-cardiac medical devices and materials. SA J Radiol 2019;23:1729.
  3. Baratella E, Marrocchio C, Bozzato AM, Roman-Pognuz E, Cova MA. Chest x-ray in intensive care unit patients: what there is to know about thoracic devices. Diagn Interv Radiol 2021;27:633-8. https://doi.org/10.5152/dir.2021.20497
  4. Gefter WB, Post BA, Hatabu H. Commonly missed findings on chest radiographs: causes and consequences. Chest 2023;163:650-61. https://doi.org/10.1016/j.chest.2022.10.039
  5. Kishimoto K, Watari T, Tokuda Y. Pseudo-pneumothorax: skin fold is an excellent imitator. BMJ Case Rep 2018;2018:bcr2018226360.
  6. Niazi AK, Minko P, Nahrstedt CJ, et al. A case of pseudo-pneumothorax with complications. Cureus 2018;10:e3263.
  7. Zarogoulidis P, Kioumis I, Pitsiou G, et al. Pneumothorax: from definition to diagnosis and treatment. J Thorac Dis 2014;6(Suppl 4):S372-6.
  8. Robin ED, Burke CM. Routine chest x-ray examinations. Chest 1986;90:258-62. https://doi.org/10.1378/chest.90.2.258
  9. Petersen GW, Baier H. Incidence of pulmonary barotrauma in a medical ICU. Crit Care Med 1983;11:67-9. https://doi.org/10.1097/00003246-198302000-00002
  10. Chiles C, Ravin CE. Radiographic recognition of pneumothorax in the intensive care unit. Crit Care Med 1986;14:677-80. https://doi.org/10.1097/00003246-198608000-00002
  11. Waite S, Scott J, Gale B, Fuchs T, Kolla S, Reede D. Interpretive error in radiology. AJR Am J Roentgenol 2017;208:739-49. https://doi.org/10.2214/AJR.16.16963
  12. Uppot RN, Sahani DV, Hahn PF, Gervais D, Mueller PR. Impact of obesity on medical imaging and image-guided intervention. AJR Am J Roentgenol 2007;188:433-40. https://doi.org/10.2214/AJR.06.0409
  13. Eisenhuber E, Schaefer-Prokop CM, Prosch H, Schima W. Bedside chest radiography. Respir Care 2012;57:427-43. https://doi.org/10.4187/respcare.01712
  14. Kattea MO, Lababede O. Differentiating pneumothorax from the common radiographic skinfold artifact. Ann Am Thorac Soc 2015;12:928-31. https://doi.org/10.1513/AnnalsATS.201412-576AS
  15. Bruno MA, Walker EA, Abujudeh HH. Understanding and confronting our mistakes: the epidemiology of error in radiology and strategies for error reduction. Radiographics 2015;35:1668-76. https://doi.org/10.1148/rg.2015150023