Continuous diaphragm sign in a patient with barotrauma

(A) Chest radiograph in a patient on positive pressure ventilation shows a radiolucent line outlining the upper margin of the diaphragm (arrows), a finding known as the continuous diaphragm sign. Also note subcutaneous emphysema in the neck, streaks in the mediastinum tracking into the lower neck, and a radiolucent line outlining the left margin of the mediastinum (arrows).
(B) Coronal reformation chest computed tomography image better demonstrates the linear lucencies (arrows) in the mediastinum diagnostic of pneumomediastinum. The pneumomediastinum also outlines the main pulmonary artery and aorta (arrowheads). Also noted is subcutaneous emphysema.