Hello and welcome to the zero to finals podcast.

My name is Tom and in this episode I'm going to be talking to you about pneumothorax.

And you can find written notes on this topic at zero to finals.com slash pneumothorax

or in the respiratory section of the second edition of the zero to finals medicine book.

So let's get straight into it.

A pneumothorax occurs when air enters the plural space, separating the lung from the chest wall.

It can occur spontaneously or secondary to trauma, medical interventions, where it's

termed iotrogenic, or lung pathology. The typical patient in exams is a tall, thin, young man

presenting with sudden breathlessness and pleuritic chest pain, possibly while playing sports.

Let's go through the causes. The top causes are spontaneous pneumothorax, trauma,

aetrogenic, for example, due to a lung biopsy, mechanical ventilation or central line insertion, and lung pathologies such as

infection, asthma or COPD.

Next let's talk about the investigations. An erect chest x-ray is the initial investigation of

choice for diagnosing a simple pneumothorax.

It shows an area between the lung tissue and the chest wall

where there's no lung markings.

There will be a line that demarcates the edge of the lung

where the lung markings end and the pneumothorax begins.

Measuring the size of the pneumothorax on a chest x-ray can be done according to the British

Thoracic Society or BTS guidelines from 2010. This involves measuring horizontally from the

lung edge to the inside of the chest wall at the level of the high limb.

A CT thorax can detect a pneumothorax that is too small to be seen on a chest x-ray,

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