Hemothorax or not: Use of extrapleural fat sign

Extrapleural hematoma is a collection located between the chest wall and the parietal pleura and is usually associated with rib fractures. Computed tomography is an excellent modality to diagnose extrapleural hematoma and rib fractures as well as differentiate it from a pleural collection. Extrapleural hematoma needs to be differentiated from a hemothorax for appropriate management. We hereby report a case of a large extrapleural hematoma and associated pleural effusion following trauma being managed as a hemothorax based only on chest radiograph appearance.