If a patient with suspected pneumothorax is hemodynamically stable, which imaging modality is typically used first?

• A. Chest radiography
• B. Point-of-care ultrasound
• C. CT scan
• D. MRI

Answer: (A)

Chest radiography is used first because it’s quick, widely available, and usually sufficient to confirm a pneumothorax and assess related injuries in a hemodynamically stable patient. Point-of-care ultrasound can rapidly detect pneumothorax at the bedside and is especially valuable when time is critical or the patient is unstable, but it relies on operator skill and can miss small or difficult-to-visualize pneumothoraces. CT scan offers the most sensitive detection and can find very small or occult pneumothoraces, yet it requires transporting the patient, exposes them to higher radiation, and takes more time, so it’s not the initial step in stable patients. MRI isn’t practical for acute pneumothorax due to longer imaging times and logistics.