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Associated findings such as air surrounding other mediastinal structures, such as the esophagus or great vessels may be present. Subcutaneous emphysema or air tracking into the neck may also be seen. This sign may also be diagnosed in X-ray images, although the sensitivity is much lower than that of CT. [4]
Emphysema is a respiratory disease of the lower respiratory tract. [7] It is commonly caused by tobacco smoking but some people are affected who have never smoked. [14] The presence of emphysema is a clear risk factor for lung cancer, made stronger in those who smoke. [20] Early symptoms of emphysema vary.
Hamman's sign (rarely, Hammond's sign [1] or Hammond's crunch [2]) is a medical sign consisting of a crunching, rasping sound, synchronous with the heartbeat, [3] heard over the precordium in spontaneous mediastinal emphysema. It is thought to result from the heart beating against air-filled tissues.
Signs and symptoms of spontaneous subcutaneous emphysema vary based on the cause, but it is often associated with swelling of the neck and chest pain, and may also involve sore throat, neck pain, difficulty swallowing, wheezing and difficulty breathing. [5] Chest X-rays may show air in the mediastinum, the middle of the chest cavity. [5]
After obtaining the patient's respiratory rate, the examiner looks for any signs of respiratory distress, which may include: Cyanosis, a bluish tinge of the extremities (peripheral cyanosis), or of tongue (central cyanosis) [4] Pursed-lip breathing [5] Accessory muscle use, including the scalene and intercostal muscles [5]
A reduction in the size of one side of the chest (hemithorax) on an X-ray or CT scan of the chest suggests chronic scarring. [6] Signs of the underlying disease causing the fibrothorax are also occasionally seen on the X-ray. [6] A CT scan may show features similar to those seen on a plain X-ray. [7]