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Unilateral hyperlucent hemithorax – when one side of the chest…

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Unilateral hyperlucent hemithorax – when one side of the chest is more lucent (black) than the other on a frontal chest radiograph. There are many potential causes including a few tricky ones. Some important things to consider:

  • rotated patient – can create a dramatic density difference
  • chest wall soft-tissue differences - particularly mastectomy (left image)
  • pneumothorax – always important! (right image)
  • air-trapping – particularly inhaled foreign bodies (check valve effect)
  • reduced lung vascularity – eg. pulmonary embolism (Wetermark’s sign)
  • contralateral increased density – eg. pleural effusion on other side

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