OBJECTIVE. We performed this study to characterize the clinical and ra
diologic manifestations of apical lung hernias. CONCLUSION. Apical lun
g hernias typically manifest as unilateral, right-sided air radiolucen
cies at the thoracic inlet on chest radiographs. They are frequently i
ntermittent and can cause lateral tracheal deviation. Radiologic studi
es performed at midinspiration may not show hernias. Airway fluoroscop
y or CT performed at maximal inspiration may be necessary to confirm t
he diagnosis.