Objective: To evaluate whether an expiratory chest roentgenogram adds anything to the results obtained by a standard inspiratory chest roentgenogram in patients with a pneumothorax.
Design: Retrospective analysis and blinded re-evaluation of the radiographs.
Setting: Free University Hospital, Amsterdam.
Method: Of 59 patients with a proven pneumothorax the chest roentgenograms at the time of the pneumothorax (54 inspiratory and 46 expiratory roentgenograms) were evaluated independently by 4 investigators in random order, as were 28 roentgenograms of the same patients made on different occasions.
Results: On all expiratory chest roentgenograms the pneumothorax was seen, of the 54 inspiratory ones two investigators missed one very small apical pneumothorax. All 28 control roentgenograms were scored correctly. No reliable additional information was obtained from the expiratory X-rays with regard to the cause of the pneumothorax.
Conclusion: Expiratory chest roentgenograms are not indicated as a routine investigation for patients in whom pneumothorax is suspected.