Clinical Presentation
Adult patient with severe chest pain and worsening subcutaneous emphysema after placement of chest tube for left-sided pneumothorax.
Imaging Findings
(A–C) Computed tomography (CT) of the chest: Axial images at three different levels demonstrate a left-sided thoracostomy tube with its tip within the fat of the anterior mediastinum (thick black arrows), as well as a significant degree of pneumomediastinum and subcutaneous emphysema (thin black arrows). Bilateral parenchymal opacities are also noted.
Differential Diagnosis
• Malposition of a thoracostomy tube:

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