Diagnosis

• Erect CXR—blunting of hemidiaphragm and progressive loss of basal lung field

• Supine CXR—increased opacity of affected hemithorax plus decreased clarity of cardiac contour on that side.

• Large bore needle aspiration to confirm presence of blood. A small bore needle may be unable to aspirate a haemothorax if it has clotted.

rim of air on erect X-ray

reverse sulcus sign of supine pneumothorax

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