Pneumothorax on shoulder X-ray

This sort of x-ray appears more commonly in radiology exams than in real life, but it illustrates an important point about remembering to look at the whole image rather than just focusing on what has been asked about. In this example, the shoulder radiographs were requested for a 75-year-old woman who was complaining of shoulder pain after falling on her left side. There was no fracture or dislocation around the shoulder, however there was a large unexpected pneumothorax. Subsequent CXR showed a rib fracture.