A 20 year-old female presents with bilateral neck pain that occurred at rest. No other complaints. See if you can find the subtle clue on the x-ray...
The x-ray shows air in the soft tissue of the right neck and supraclavicular area. Close inspection of the mediastinum reveals subtle air along the heart border. Diagnosis: pneumomediastinum.
Often the first clue of pneumomediastinum is air in the neck and supraclavicular area on plain film. So, always look at the soft tissues on chest x-ray.
