64 year old male with emphysema and stage 4 lung cancer presents in respiratory distress. What's the diagnosis?
Answer: Pneumothorax (left chest) and bullous disease (right chest).
In questionable cases like this, bedside ultrasound can help distinguish between bullae and pneumothorax. Bullae should have a positive lung sliding sign whereas pneumothorax does not.
See the referenced case report for more information:
Simon, B. et al. Two cases where bedside ultrasound was able to distinguish pulmonary bleb from pneumothorax. J Emerg Med. 2005 Aug;29(2):201-5.
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