Pneumothorax and subcutaneous emphysema – CT

Subcutaneous emphysema. This 39 year old man was in a high-speed road traffic accident. This CT image, on lung windows, demonstrates a large right pneumothorax (note that a chest drain has been inserted), dense consolidation in the posterior aspect of his right lung (which was due to a pulmonary contusion, but aspiration could have a similar appearance), and extensive subcutaneous emphysema extending along the right chest wall. There is also a pneumomediastinum, with air outlining the thoracic aorta (arrow).