Deep sulcus sign
Encyclopedia
In radiology
, the deep sulcus sign on a supine chest radiograph is an indication of a pneumothorax
. In a supine
film (common in the ICU
), it may be the only indication of a pneumothorax because air collects anteriorly and basally, within the nondependent portions of the pleural space as opposed to the apex
(of the lung
) when the patient is upright. The costophrenic angle
is abnormally deepened when the pleural air collects laterally, producing the deep sulcus sign. Patients with chronic obstructive pulmonary disease
(COPD) may exhibit deepened lateral costophrenic angles due to hyperaeration of the lungs and cause a false deep sulcus sign.
Radiology
Radiology is a medical specialty that employs the use of imaging to both diagnose and treat disease visualized within the human body. Radiologists use an array of imaging technologies to diagnose or treat diseases...
, the deep sulcus sign on a supine chest radiograph is an indication of a pneumothorax
Pneumothorax
Pneumothorax is a collection of air or gas in the pleural cavity of the chest between the lung and the chest wall. It may occur spontaneously in people without chronic lung conditions as well as in those with lung disease , and many pneumothoraces occur after physical trauma to the chest, blast...
. In a supine
Supine position
The supine position is a position of the body: lying down with the face up, as opposed to the prone position, which is face down, sometimes with the hands behind the head or neck. When used in surgical procedures, it allows access to the peritoneal, thoracic and pericardial regions; as well as the...
film (common in the ICU
Intensive Care Unit
thumb|220px|ICU roomAn intensive-care unit , critical-care unit , intensive-therapy unit/intensive-treatment unit is a specialized department in a hospital that provides intensive-care medicine...
), it may be the only indication of a pneumothorax because air collects anteriorly and basally, within the nondependent portions of the pleural space as opposed to the apex
Apex (geometry)
In geometry, an apex is the vertex which is in some sense the highest of the figure to which it belongs.*In an isosceles triangle, the apex is the vertex where the two sides of equal length meet, opposite the unequal third side....
(of the lung
Lung
The lung is the essential respiration organ in many air-breathing animals, including most tetrapods, a few fish and a few snails. In mammals and the more complex life forms, the two lungs are located near the backbone on either side of the heart...
) when the patient is upright. The costophrenic angle
Costophrenic angle
In anatomy, the costophrenic angles are the places where the diaphragm meet the ribs .Each costophrenic angle can normally be seen as on chest x-ray as a sharply-pointed, downward indentation between each hemi-diaphragm and the adjacent chest wall . A small portion of each lung normally reaches...
is abnormally deepened when the pleural air collects laterally, producing the deep sulcus sign. Patients with chronic obstructive pulmonary disease
Chronic obstructive pulmonary disease
Chronic obstructive pulmonary disease , also known as chronic obstructive lung disease , chronic obstructive airway disease , chronic airflow limitation and chronic obstructive respiratory disease , is the co-occurrence of chronic bronchitis and emphysema, a pair of commonly co-existing diseases...
(COPD) may exhibit deepened lateral costophrenic angles due to hyperaeration of the lungs and cause a false deep sulcus sign.
