Pneumomediastium | Figure 1

CincyKidsRad

Cincinnati Children's Radiology

Pneumomediastium

An upper abdomen radiograph (image 1) displays a linear lucency (arrow) in the left paraspinal region. Further imaging of the upper chest (image 2) shows air tracking to the neck, consistent with pneumomediastinum. Pneumomediastinum can occasionally extend into the abdomen through the diaphragmatic crura, although it more typically extends to the neck.

Similar cases

47 yo inmate presents to the ED with "swollen neck" #Dysphagia and unable to tolerate secretions. Definite #Crepitus on exam. Xray shows free air around soft tissues of the neck. CT shows #Pneumomediastinum with an esophageal foreign body and probable perforation.](https://app.figure1.com/case-detail/1a918a3a-141d-4f88-b888-935515b7ff72)

Chest x-ray in an infant with recent cardiac surgery and dextrocardia shows pneumopericardium (arrow). Pneumopericardium is an incredibly uncommon finding and is almost always associated with recent cardiothoracic surgery. Pneumopericardium can be differentiated from pneumomediastinum by the shape of the air collection. Pneumopericardium outlines the cardiac apex while pneumomediastinum is continuous at the base of the heart giving a continuous diaphragm sign. More superiorly, pneumopericardium continues to outline the heart, while pneumomediastinum outlines the mediastinal structures and extends to the base of the neck.](https://app.figure1.com/case-detail/204be124-4483-47bb-b73b-489493391a60)

Chest radiograph (image 1) in a newborn shows a massive lymphatic malformation involving the chest wall extending into the upper extremities. Focused ultrasound of the right chest (image 2) shows that the malformation has a heterogeneous appearance with cystic spaces, solid appearing spaces, and spaces with hypoechoic fluid. The hypoechoic fluid is shown to be layering and mobile on real-time imaging (image 3). Lymphatic malformations are benign congenital lesions. They most commonly occur in the head and neck region but can appear anywhere within the body. Typically, lymphatic malformations are classified according to the diameter of the largest cystic cavity and can be microcystic or macrocystic. Macrocystic lesions have cystic space is larger than 2 cm in diameter.](https://app.figure1.com/case-detail/27c675dd-6957-4d49-ad97-73b83f63e4bf)

Frontal (image 1) and lateral (image 2) chest x-ray in an infant shows the normal thymus (arrow) creating an opacity in the right upper lobe. The thymus can be differentiated from right upper lobe pneumonia by the way the thymus fades as it extends laterally and posteriorly. #ThoraxThursday #ThoracicThursday](https://app.figure1.com/case-detail/2b8b6746-c46b-4d1c-b239-191d91741bac)