Tracheal Deviation

MANUAL OF CLINICAL DIAGNOSIS

Tracheal deviation is an anatomical alteration where the trachea shifts from its usual central position in the neck. This deviation may indicate the presence of serious pathological conditions affecting the mediastinum, lungs, pleura, or the skeletal structure of the thorax. Identifying the underlying cause is crucial, as some of these conditions can be life-threatening and require immediate medical intervention.

Pathology	Clinical Symptoms and Signs	Suspected Diagnosis	Confirmatory Diagnosis
Contralateral Tension Pneumothorax	Severe dyspnoea, chest pain, decreased breath sounds, hypotension	Medical history, physical examination, contralateral tracheal deviation	Chest X-ray, chest computed tomography (CT)
Ipsilateral Pneumothorax	Dyspnoea, chest pain, decreased breath sounds on the affected side	Medical history, physical examination, ipsilateral tracheal deviation	Chest X-ray, chest CT
Ipsilateral Upper Lobe Collapse	Dyspnoea, cough, chest pain, decreased breath sounds on the affected side	Medical history, physical examination, ipsilateral tracheal deviation	Chest X-ray, chest CT
Contralateral Pleural Effusion	Dyspnoea, chest pain, dull percussion, decreased breath sounds	Medical history, physical examination, contralateral tracheal deviation	Chest X-ray, thoracic ultrasound, chest CT
Scoliosis	Abnormal spinal curvature, thoracic asymmetry, back pain	Physical examination, observation of spinal curvature	Spinal X-ray, chest CT