Unilateral hyperlucent hemithorax :

CRAWLS
• C: contralateral lung increased density, e.g. supine pleural effusion
• R: rotation
• A: air, e.g. pneumothorax
• W: wall, e.g. chest wall mass, mastectomy, polio, Poland syndrome, surgical removal of pectoralis major
• L: lungs, e.g. airway obstruction, emphysema, Swyer-James syndrome, unilateral large bullae, large
pulmonary embolus
• S: scoliosis

SAFE POEM
• S: Swyer-James syndrome
• A: agenesis (pulmonary)
• F: fibrosis (mediastinal)
• E: effusion (pleural effusion on the contralateral side)
• P: pneumonectomy/pneumothorax
• O: obstruction
• E: embolus (pulmonary)
• M: mucous plug
ACROSSS

• A: air- pneumothorax
artery - pulmonary aplasia or hypoplasia

• C: chest wall - mastectomy, polio, Poland syndrome

• R: rotated film
• O: obstructive causes - airway obstruction, foreign body, unilateral emphysema, or large embolus
• S: scoliosis
• S: surrounding - increased density in contralateral lung, e.g. pleural effusion in opposite lung in a
recumbent patient
• S: Swyer-James syndrome (Macleod syndrome).