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Lung Cancer (a) Diagnosis and Causes, Smoking Habits, etc.
Published in Fred W Wright, Radiology of the Chest and Related Conditions, 2022
These are protean, but most common are cough, haemoptysis, chest pain, dyspnoea, loss of weight and abdominal symptoms. In the author's view, every patient with chest symptoms should have a minimum of a high KV chest radiograph and further views if any abnormality is suspected on this or clinically. Likewise all patients over 40 with abdominal symptoms not otherwise explained should also have a chest radiograph. Several cases of bronchial carcinoma were thus found in the author's department each year and also the occasional case by pre-operative chest radiographs before other major surgery. The 'best case' to find is the asymptomatic one with no demonstrable spread and well differentiated histology, i.e. the 'chance-finding' of an early tumour.
Paper 2
Published in Amanda Rabone, Benedict Thomson, Nicky Dineen, Vincent Helyar, Aidan Shaw, The Final FRCR, 2020
Amanda Rabone, Benedict Thomson, Nicky Dineen, Vincent Helyar, Aidan Shaw
A 50 year old male is under investigation by the endocrinology team for a hormonal disorder. A chest radiograph is performed. There is a well-defined lucent and expansile lesion in the lateral aspect of a left sided rib. CT chest demonstrates the lesion well. There is no associated periosteal reaction. Further scrutiny of the distal clavicle demonstrates subperiosteal bone resorption. Following a period of treatment, the lucent lesion resolves.
Tuberculosis in Childhood and Pregnancy
Published in Lloyd N. Friedman, Martin Dedicoat, Peter D. O. Davies, Clinical Tuberculosis, 2020
Lindsay H. Cameron, Jeffrey R. Starke
Radiographic improvement of intrathoracic disease in children occurs very slowly. A common practice is to obtain a chest radiograph at diagnosis and 4–8 weeks into therapy to be sure that no progression or unusual changes have occurred. If these radiographs are satisfactory, interim chest radiographs are not necessary, and an end of treatment radiograph is recommended. A significant proportion of children with intrathoracic adenopathy have abnormal radiographic findings for 1–3 years, after effective antituberculosis treatment has been completed. If clinical and radiographic improvement has occurred after 6 months of therapy, medications can be discontinued, and the child can be followed at intervals of 6–12 months with appropriate chest radiographs to determine continued improvement in radiographic appearance.
Iatrogenic pneumothorax after breast reduction surgery caused by local anesthesia infiltration – a case report
Published in Case Reports in Plastic Surgery and Hand Surgery, 2022
Marko T. Ristola, Ilkka Koskivuo, Salvatore Giordano
In a series of 1322 procedures on 1152 patients, iatrogenic pneumothorax as a result of thoracic paravertebral blockade was described in 0.26%. The article describes using a single-shot T2/3 technique to achieve analgesia for both the breast and the axilla. The surgical procedures included wide local excision and sentinel node biopsy (495 patients), wide local excision (265 patients), mastectomy and axillary clearance (82 patients), mastectomy and sentinel node biopsy (72 patients), bilateral mastectomy (49 patients), axillary clearance (42 patients), wide local excision and axillary clearance (40 patients), bilateral wide local excision (27 patients), change of implants (27 patients), sentinel node biopsy (23 patients), bilateral reduction (17 patients), unilateral reduction (14 patients), and mastectomy and reconstruction (9 patients). Of these patients, a postoperative chest radiograph was taken in 37 patients (3.2%), mainly due to desaturation, chest pain, or suspicion of pleural puncture during the blockade procedure. All of the patients in this series could be managed conservatively without the need for pleural drainage [8]. Similarly, we do not recommend to perform chest radiographs routinely after breast reduction surgery without clinical indications.
Clarithromycin-Induced Visual Hallucinations
Published in Neuro-Ophthalmology, 2022
Daragh McGee, Cathal Hanley, Audrey Reynolds, Shane Smyth
A complete blood count including white cell count (6.7 x 109/L [normal range [NR] 3.5–11.0 x 109/L]), renal and liver profiles, thyroid function tests, vitamin B-12, folate levels and C-reactive protein (4 mg/L [NR <7 mg/L]) were within the normal reference ranges. A chest radiograph was normal. Urine microscopy and COVID-19 nasopharyngeal swab were negative for infection. There was no significant stenosis of the vasculature of the head and neck on computed tomography angiography. Non-contrast magnetic resonance imaging (MRI) of the brain showed changes in keeping with moderate chronic microvascular ischaemia including two small microbleeds in the pons and right temporal lobe. There was no evidence of an intracranial mass or acute infarction. An electroencephalogram (EEG) was not performed.
Does the initial chest radiograph severity in COVID-19 impact the short- and long-term outcome? – a perspective from India
Published in Infectious Diseases, 2022
Maria M. D’souza, Aruna Kaushik, Jeanne Maria Dsouza, Ratnesh Kanwar, Vivek Lodhi, Rajnish Sharma, Anil Kumar Mishra
Chest radiograph anteroposterior (AP) projections were taken at the time of presentation on a digital portable X-Ray unit. Radiographic features such as ground-glass opacification and consolidation were described as per the glossary of terms for thoracic imaging of the Fleischner Society [6]. Distribution of lung lesions was classified as peripheral (involving predominantly the peripheral third of the lungs), central (involving predominantly the inner two-third of the lungs) or both (involving both central and peripheral part of the lungs). Note was also made of whether the lesion was unilateral or bilateral. Additionally, a semiquantitative assessment of lesion load was made using the Brixia scoring system [7]. The lung was accordingly divided into three zones – upper, middle and lower. The upper zone was limited inferiorly up to the level of the inferior wall of the aortic arch. The middle zone was delineated between the inferior wall of the aortic arch and the right inferior pulmonary vein while the lower zone was below the right inferior pulmonary vein. Each zone was subsequently scored depending on the pattern of pulmonary infiltration in the manner adopted by Balbi et al. [8] as follows: 0 – if no infiltrates, 1 – if only ground-glassing, 2 – if mixed pattern of ground-glassing and consolidation and 3 – if pure consolidation. The individual scores in each zone were then summated to obtain the overall score. The number of zones involved was also noted. All CXRs were assessed by a trained radiologist with over 23 years experience.