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ENGINE 07 • Royal College of Radiologists (RCR) Curated Editorial Lead: Medstufise Diagnostic Imaging Faculty

Imaging Atlas

Annotated X-Ray, CT, MRI and Ultrasound modalities

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Radiology Diagnostic Viewer & Pathology Pinpoint

Interactive radiographic anatomy viewer with toggleable clinical overlays, diagnostic hotspots, and comparison sliders.

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Erect PA Chest Radiograph: Large Tension Pneumothorax
Hyperlucent right hemithorax with complete collapse of the right lung toward the hilum. Notice the profound flattening of the right hemidiaphragm and contralateral tracheal/mediastinal shift.
📍 1. Sharp Visceral Pleural Edge
📍 2. Absent Peripheral Lung Markings
📍 3. Contralateral Tracheal Shift
📍 4. Depressed Hemidiaphragm
Modality Protocol Erect PA vs Supine Deep Sulcus Sign
Reporting Urgency Immediate Bedside Red Flag Alert
Actionable Intervention Decompress before tube thoracostomy

Clinical Reference Summaries (1)

Peer-reviewed diagnostic & management guides
Radiology / Emergency
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Tension & Spontaneous Pneumothorax on Chest X-Ray

Visceral pleural lines, deep sulcus sign, and mediastinal shift identification

Bedside Pearl

Tension pneumothorax is a clinical diagnosis. Never wait for an X-ray if the patient is hypotensive, tachycardic, and has unilateral absent breath sounds.

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