Wednesday, August 10, 2005

Wednesday CxR rounds

What is the diagnosis?



update: after reading the comments, see the answer here

9 comments - CLICK HERE to read & add your own!:

Jennings said...

The resolution is not too good on my work computer. I think I see some bibasilar haziness and maybe lateral pleural thickening, is that correct or is it my resolution?

Baleeiro said...

There is indeed some bibasilar haziness...

Mendez said...

All I can make out is possibly diffusely increased interstitial markings with decreased lucency at the bases. I can make out diaphragmatic and heart borders reasonably well (I think). I suspect I'm missing something I can't make out well on my monitor.

So based upon this my differential would have to be pretty broad (diffusely increased interstitial markings). Just about any IIP, CHF, secondary causes of ILD (collagen vascular diseases, sarcoid).

Baleeiro said...

Look up on the left upper corner...

Jennings said...

Does he have a left clavicular fracture?

Baleeiro said...

A little higher and lateral to the clavicle...

Mendez said...

OK- after staring at this until I've gone somewhat cross-eyed, are you referreing to the Left marker being inappropriately placed on the right side. Or, if that truly is the left side with the image reversed (and thus, the marker is actually backwards)then the patient has situs inversus?

Jennings said...

Wow mendez is right. Good call baw, if that's what this turns out to be.

Baleeiro said...

All right, Mendez! This is a new patient I saw yesterday afternoon with situs inversus secondary to Kartagener's. Her CT scan shows complete situs inversus (pretty cool) and minimal bronchiectasis in her left middle lobe (as opposed to her right lingula). I will post some CT images tomorrow.