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Arch Emerg Med. 1993 December; 10(4): 343–346.
PMCID: PMC1286047

Detection of pneumothorax by accident and emergency officers and radiologists on single chest films.


To assess whether an accurate diagnosis of pneumothorax can be made on a single chest film, 233 pairs of inspiratory (I) and expiratory (E) chest films taken in an accident and emergency (A&E) department for suspected pneumothorax were reviewed by two A&E officers and three radiologists. The films were assessed for the presence of pneumothorax by viewing the I film in isolation and, after an interval, by viewing the paired I and E films together. Fifty-four of the patients had a pneumothorax. The five observers missed 23 pneumothoraces (8.5% of total) on the I film alone which were correctly diagnosed on the paired I and E films, the three radiologists missed 10/162 pneumothoraces on the I film alone which were correctly identified on the I and E films (6%) and the two A&E officers 13/108 (12.5%). The use of a single inspiratory chest film for suspected pneumothorax could result in pneumothoraces being missed, particularly by less experienced observers and therefore we believe that paired I and E films should continue to be used routinely for suspected pneumothorax.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.
  • Bradley M, Williams C, Walshaw MJ. The value of routine expiratory chest films in the diagnosis of pneumothorax. Arch Emerg Med. 1991 Jun;8(2):115–116. [PMC free article] [PubMed]
  • Greene R, McLoud TC, Stark P. Pneumothorax. Semin Roentgenol. 1977 Oct;12(4):313–325. [PubMed]

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