Case submitted by Elie Goulding, M.D., radiologist, to

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A young child presents with shortness of breath and distress. The chest X-Ray (CXR) demonstrates large left-sided lucency relative to right hemithorax. Deep sulcus sign is also demonstrated on the left side. There is also slight rightward mediastinal shift. Splaying of ribs is not definite, but there is suggestion of possible splaying at certain levels.

Evaluation for tension pneumothorax would be critical which would include mediastinal shift, splaying of ribs, for instance. Serial imaging would also be important to assess if the pneumothorax is worsening.

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What is your diagnosis of a young child who presents with shortness of breath and distress? 

Image IQ Quiz: Patient Presents with Shortness of Breath and Distress