PMC8694274_01
Chest X-ray PA view of the patient on the day of admission shows a "continuous diaphragm sign" characterised by a mediastinal gas outlining the superior surface of the diaphragm and separating it from the heart (black arrowheads) and a "Naclerio's V sign" in which mediastinal gas outlines the lateral margin of the descending aorta and extends laterally over the left hemidiaphragm (red arrowheads).
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A chest X-ray showed pneumomediastinum along the left cardiac border and over the cardiomediastinal silhouette anteriorly with extensive subcutaneous emphysema in the neck's soft tissues (Figures 1 and 2).
Chest X-ray (lateral view) demonstrating lucency (Yellow arrows) overlying the heart signifying pneumopericardium.
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A chest X-ray showed pneumomediastinum along the left cardiac border and over the cardiomediastinal silhouette anteriorly with extensive subcutaneous emphysema in the neck's soft tissues (Figures 1 and 2).
CT imaging demonstrating dissection of fascial planes in neck and invasion of trapped air into the spinal canal (yellow arrows) via intervertebral foramen.
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A chest CT showed pneumopericardium and pneumomediastinum with air dissecting throughout the mediastinum, into the neck, down into the spinal canal, posterior paraspinal musculature as well as adjacent chest wall musculature (Figures 3 and 4).
Pneumorachis demonstrated in axial (black arrow) (A) and sagittal sections (B) of thoracic CT imaging (yellow arrow).
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A chest CT showed pneumopericardium and pneumomediastinum with air dissecting throughout the mediastinum, into the neck, down into the spinal canal, posterior paraspinal musculature as well as adjacent chest wall musculature (Figures 3 and 4).
STROBE diagram depicting the selection process stepwise during the literature search for articles on nonspontaneous pneumorachis.
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The STrengthening, the Reporting of Observational studies in Epidemiology (STROBE) diagram, mentions in detail the steps of screening and scrutinizing the various articles during the selection process of the articles for this review (Figure 5). Hence, 48 articles detailing 49 cases published from 1994 till March 2021 were included in the final interpretation and discussion (Figure 5).