Pneumomediastinum diagnostic study of choice: Difference between revisions
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The diagnostic study of choice for pneumomediastinum is CT-scan of the chest. | The diagnostic study of choice for pneumomediastinum is CT-scan of the chest. | ||
===== Diagnostic results ===== | ===== Diagnostic results ===== | ||
Revision as of 21:44, 12 December 2018
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Trusha Tank, M.D.[2]
Overview
Pneumomediastinum can present with a various range of symptoms from sudden acute chest pain, SOB, cough to no symptoms at all. Diagnosis of pneumomediastinum depends on the associated or precipitating condition. On physical exam, pneumomediastinum is associated with a specific sign known as Hamman's sign, which is the presence of mediastinal crunch or click present on auscultation over the cardiac apex and the left sternal border synchronous with the heartbeat. pneumomediastinum can routinely be diagnosed by chest X-ray. Diagnostic investigation of choice for pneumomediastinum is CT-scan of the chest.
Diagnostic Study of Choice
Study of choice
The diagnostic study of choice for pneumomediastinum is CT-scan of the chest.
Diagnostic results
The following finding(s) on performing CT-scan of the chest is confirmatory for pneumomediastinum:
- Subcutaneous emphysema.
- Naclerio V sign: Seen in pneumomediastinum occurring often secondary to an oesophageal rupture but it is not entirely specific to that condition.
- Gas anterior to pericardium: pneumopericardium.
- Gas around pulmonary artery and main branches: ring around artery sign.
- Gas outlining major aortic branches: tubular artery sign.
- Gas outlining bronchial wall: double bronchial wall sign.
- Continuous diaphragm sign: due to gas trapped posterior to pericardium.
- Gas between parietal pleura and diaphragm: extrapleural sign.
- Gas in pulmonary ligament.
Pediatric pneumomediastinum have different appearances:
- Elevated thymus: thymic wing sign.
- Gas crossing the superior mediastinum: haystack sign (the heart appears like a haystack in a Monet painting).
Sequence of Diagnostic Studies
The [name of investigation] must be performed when:
- The patient presented with symptoms/signs 1, 2, and 3 as the first step of diagnosis.
- A positive [test] is detected in the patient, to confirm the diagnosis.
OR
The various investigations must be performed in the following order:
- [Initial investigation]
- [2nd investigation]
Name of Diagnostic Criteria
It is recommended that you include the criteria in a table. Make sure you always cite the source of the content and whether the table has been adapted from another source.
[Disease name] is primarily diagnosed based on clinical presentation. There are no established criteria for the diagnosis of [disease name].
OR
There is no single diagnostic study of choice for [disease name], though [disease name] may be diagnosed based on [name of criteria] established by [...].
OR
The diagnosis of [disease name] is made when at least [number] of the following [number] diagnostic criteria are met: [criterion 1], [criterion 2], [criterion 3], and [criterion 4].
OR
The diagnosis of [disease name] is based on the [criteria name] criteria, which includes [criterion 1], [criterion 2], and [criterion 3].
OR
[Disease name] may be diagnosed at any time if one or more of the following criteria are met:
- Criteria 1
- Criteria 2
- Criteria 3
OR
IF there are clear, established diagnostic criteria
The diagnosis of [disease name] is made when at least [number] of the following [number] diagnostic criteria are met: [criterion 1], [criterion 2], [criterion 3], and [criterion 4].
OR
The diagnosis of [disease name] is based on the [criteria name] criteria, which include [criterion 1], [criterion 2], and [criterion 3].
OR
The diagnosis of [disease name] is based on the [definition name] definition, which includes [criterion 1], [criterion 2], and [criterion 3].
OR
IF there are no established diagnostic criteria
There are no established criteria for the diagnosis of [disease name].