A Skinfold Imitating a Pneumothorax

We present the case of a male patient in his late 80s who presented with a fall with symptoms and signs of community-acquired pneumonia. Chest X-ray showed the suspicion of a left-sided pneumothorax. A CT of the chest subsequently ruled out the presence of a pneumothorax on the left side. The pseudo-pneumothorax on the chest X-ray was secondary to a skinfold. This case highlights how well a skinfold can mimic pneumothorax. Careful clinical and radiological examination with bedside lung ultrasound and/or CT of the chest can help differentiate true pneumothorax from pseudo-pneumothorax, provided the patient is hemodynamically stable. Our case highlights the importance of clinical examination, various imaging modalities, and confirmation of a diagnosis before proceeding to interventional procedures in the context of limited clinical suspicion of the differential.