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Break dancing was at its peak of popularity in the 1980s, but evidently is still part of today's youth culture. There have been several reports of injuries associated with this activity, although none recently.1–4 While mainly of an orthopaedic nature, the injuries reported are quite varied. This is a report of a previously fit and healthy 16 year old non-smoking young man who was 5 foot 5 inches tall. He developed a right sided pneumothorax during an evening spent break dancing. He ignored the discomfort for a few days, and then after a visit to his general practitioner, a chest x ray confirmed the diagnosis. He required an intercostal drain for 2 days before resolution. Six months later, while again break dancing, he developed another pneumothorax, this time on the left side. Again he ignored it for a few days before consutling his GP. On this occasion, it was treated conservatively and resolved after 2 weeks without a drain, at which stage he was referred to our centre.
Examination and lung function were normal and a CT chest scan revealed tiny subpleural bullae at the apex of the left lung. He was advised to avoid break dancing, although the chance of adherence to this advice was small. Two months later he had a further recurrence on the left side (during sleep) which was treated conservatively and resolved after 2 weeks. He then underwent a left thoracotomy (which revealed multiple bullae up to 1 cm diameter over the surface of the lung) and a pleurectomy from which he made a good recovery.
To my knowledge this is the first report of a spontaneous pneumothorax associated with any form of dancing. Presumably lying on his back with his legs fully flexed increased his abdominal pressure, and possibly combined with a Valsalva manouevre, this was enough to rupture one of the bullae. Although it was the presence of bullae that was responsible for the pneumothoraces, the risk (albeit small) of pneumothorax should now be added to the list of conditions associated with break dancing.
I would like to thank Dr Sinan Al-Jawad for looking after this patient duing his acute pneumothoraces and Mr Peter Goldstraw for performing the surgery.
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