A Skinfold Imitating a Pneumothorax

TL;DR

An elderly man's chest X-ray suggested a pneumothorax, but it was actually caused by a skinfold, emphasizing the need for careful diagnosis.

Contribution

This case demonstrates how a skinfold can mimic a pneumothorax on imaging, highlighting diagnostic challenges.

Findings

A chest X-ray initially suggested a left-sided pneumothorax.

CT imaging ruled out a true pneumothorax, revealing the finding was due to a skinfold.

The case underscores the importance of using multiple diagnostic tools to avoid misdiagnosis.

Abstract

We present the case of a male patient in his late 80s who presented with a fall with symptoms and signs of community-acquired pneumonia. Chest X-ray showed the suspicion of a left-sided pneumothorax. A CT of the chest subsequently ruled out the presence of a pneumothorax on the left side. The pseudo-pneumothorax on the chest X-ray was secondary to a skinfold. This case highlights how well a skinfold can mimic pneumothorax. Careful clinical and radiological examination with bedside lung ultrasound and/or CT of the chest can help differentiate true pneumothorax from pseudo-pneumothorax, provided the patient is hemodynamically stable. Our case highlights the importance of clinical examination, various imaging modalities, and confirmation of a diagnosis before proceeding to interventional procedures in the context of limited clinical suspicion of the differential.

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