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Thoracic cases
Published in Lt Col Edward Sellon, David C Howlett, Nick Taylor, Radiology for Medical Finals, 2017
Hannah Adams, Sarah Hancox, Cristina Ruscanu, David C Howlett
The CXR shows a severe thoracic deformity with crowding of abnormally modelled ribs and absent ribs in the left upper zone (Figure 5.22B). There is left hemithoracic volume loss with tracheal dev iation to the left and a raised left hemidiaphragm. The left costophrenic angle is blunted, likely related to pleural thickening. Calcified granulomas are noted in the right upper zone and left lung.
Answers
Published in Calver Pang, Ibraz Hussain, John Mayberry, Pre-Clinical Medicine, 2017
Calver Pang, Ibraz Hussain, John Mayberry
This scenario describes pleural effusion. On examination there will be decreased expansion, stony dull percussion and diminished breath sounds on the affected side. With large effusions there may be tracheal deviation away from the effusion. Chest X-ray will show blunting of costophrenic angles.
Thorax
Published in David Heylings, Stephen Carmichael, Samuel Leinster, Janak Saada, Bari M. Logan, Ralph T. Hutchings, McMinn’s Concise Human Anatomy, 2017
David Heylings, Stephen Carmichael, Samuel Leinster, Janak Saada, Bari M. Logan, Ralph T. Hutchings
Repeated severe vomiting can lead to rupture of the oesophagus in the thorax with leakage of food and subsequent infection. Which part of the thoracic cavity will initially be affected?Superior mediastinum.Anterior mediastinum.Posterior mediastinum.Costodiaphragmatic recess.Costophrenic angle.
Idiopathic Pericardial Ossification Causing Chronic Constrictive Pericarditis
Published in Fetal and Pediatric Pathology, 2022
Sandhya Biswal, Rudra Pratap Mahapatra, Anirban Kundu, Shradha Gupta, Siddhartha Sathia, Suvradeep Mitra
The complete hemogram, coagulation profile, renal function tests, and liver function tests were within normal limits. An electrocardiography (ECG) showed sinus rhythm and notched P-wave suggesting right atrial enlargement and asymmetrical T wave inversion in V3 and V4 leads suggesting pressure overload (Figure 1a). The chest X-ray (postero-anterior and lateral views) revealed increased broncho-vascular markings with blunting of the right costophrenic angle suggesting pleural effusion. Calcific markings were noted in the right superior and left cardiac borders (Figures 1b and c). The 2 D- echocardiogram revealed septal bounce and normal cardiac chambers with normal valves. A contrast enhanced CT (CECT) scan of thorax showed constrictive pericarditis with moderate pericardial effusion and a maximum thickness of 2–3 cm at the level of left ventricle (Figure 1d). There was moderate pleural effusion with dilated inferior vena cava and hepatic veins.
Unilateral diaphragmatic dysfunction following thoracic outlet surgery diagnosed by point-of-care ultrasound
Published in Journal of Community Hospital Internal Medicine Perspectives, 2021
Wesley Cain, Sunny S. Cai, Christian Salcedo, Steven Embry, Melissa Scalise
This case was interesting because the diaphragm was evaluated using the posterolateral axillary line at the level of the costophrenic angle during the CLUE protocol. While the use of this view for evaluation of diaphragm dysfunction has not been studied, this view clearly showed a decreased excursion of the diaphragm and aided in the diagnosis. This view is used in protocols, such as CLUE, to evaluate respiratory complaints, and we believe it may also be valuable for evaluation of the diaphragm. Further study of this view and its use in evaluation of diaphragm excursion is warranted. This case is also reported because diagnosing diaphragm dysfunction using point-of-care ultrasound protocol in ambulatory patients presenting with respiratory complaints has not been published to our knowledge.
Clinical and pathophysiological characteristics of valproate-induced pleural effusion
Published in Clinical Toxicology, 2021
Stavros Tryfon, Efthymia Papadopoulou, Maria Saroglou, Dimitrios Vlachopoulos, Athina Georgopoulou, Eva Serasli, George Ismailos
The effusion was unilateral in 19 patients [7–9,11,14–28], bilateral in 9 [10,12,13,29–34], and concurred with pericardial effusion in 7 cases [18,24–26,29–31] (Tables 3 and 4). The pleural fluid was of moderate amount in 6 patients [9,10,17,18,20,27], whereas 7 presented with extensive pleural effusion reaching at least half of the hemithorax [7,8,12,14,19,25,29]. In two patients there was only blunting of the costophrenic angles [22, 34]. Peripheral eosinophilia was observed in 12 patients [10,13–15,17,19–22,27,30,33].