Dr. Pepe’s Diploma Casebook: Case 98 – A painless approach to interpretation (Chapter 5) – SOLVED!

diploma_casebook_case98

Dear Friends,

Today we are moving to a new chapter in the Painless Approach to Interpretation, addressing what to do when the chest radiograph does not show an obvious abnormality.

For this purpose I am presenting the PA and lateral radiographs of a 57-year-old man with a chronic cough. What do you see?

Examine the image below, leave your thoughts in the comments section and come back on Friday for the answer.

Read more…

Dr. Pepe’s Diploma Casebook: Case 97 – A painless approach to interpretation (Chapter 4) – SOLVED!

diploma_casebook_case97-bobk

Dear Friends,

Now that we’ve looked at the three key questions to ask when facing a chest radiograph (chapters 1, 2 and 3), we move on to the interpretation of pulmonary lesions.

Today I am showing chest radiographs of a 31-year-old woman with marked dyspnoea for the last three days.

What would you call the predominant pattern?

1. Reticulonodular
2. Septal
3. Air-space disease
4. None of the above

Check the images below, leave your thoughts in the comments and come back on Friday for the answer.

Read more…

Dr. Pepe’s Diploma Casebook: Case 96 – A painless approach to interpretation (Chapter 3) – SOLVED!

diploma_casebook_case96

Dear Friends,

I hope you remember the three questions to ask when facing a chest radiograph:

a) Is there any visible abnormality? (Chapter 1)
b) Is it intra or extrapulmonary? (Chapter 2)
c) What does it look like?

To discuss the third question, I’m showing chest radiographs of a 36-year-old woman with chest pain.

What does the lesion look like?

1. Pericardial fat pad
2. Thymic tumour
3. Pericardial cyst
4. Any of the above

Check the two images below, leave your thoughts in the comments section and come back on Friday for the solution.

Read more…

Dr. Pepe’s Diploma Casebook: Case 95 – A painless approach to interpretation (Chapter 2) – SOLVED!

diploma_casebook_case95

Dear Friends,

As you may remember from Diploma Case 94, when I’m facing a chest radiograph I start by asking three questions:

a) Is there any visible abnormality?
b) It is intra- or extrapulmonary?
c) What does it look like?

Today we will discuss the second question, showing chest radiographs in two different patients. Is the abnormality intra- or extrapulmonary? Check the images below, leave your thoughts in the comments and come back for the answer and discussion on Friday.

Read more…

Dr. Pepe’s Diploma Casebook: Case 94 – A painless approach to interpretation (Chapter 1) – SOLVED!

Diploma_casebook_case94

Dear Friends,

This year I intend to discuss the basic principles of interpreting chest radiographs, under the heading, “The Beauty of Basic Knowledge”.

I plan to structure the discussion into three main parts, which will take us through the whole academic year:

Part 1. A painless approach to interpretation
Part 2. To err is human: how to avoid slipping up
Part 3. The wisdom of Dr. Pepe

This week’s case is the first chapter of my ‘painless approach to interpretation’. Interpreting chest radiographs is not difficult if we follow Confucius’ saying: “ A journey of a thousand miles begins with a single step”. As a clinical radiologist, my first step is to ask myself three questions:

a) Is there any visible abnormality?
b) It is intra or extrapulmonary?
c) What does it look like?

Today I’ll discuss the first question. Below you can see the chest radiographs of three different patients. Do you see any visible abnormality in any of them? Let me know in the comments section and come back on Friday for my answer.

Read more…

Dr. Pepe’s Diploma Casebook: Case 93

Diploma_casebook_case93

Dear Friends

This is the last case of the first semester. It has been a hard year and I need some quiet time. Will see you again on Monday, September 5 with new cases. Relax and enjoy your vacation!

This week’s case follows the pattern of a ‘Meet the Examiner’ presentation, with questions and answers similar to a real examination. Take your time before scrolling down for the answer. And no peeking!

The images were obtained during routine CT screening in a 72-year-old man, heavy smoker.

What would be your diagnosis?

1. Carcinoma in LUL and cyst in LLL
2. Carcinoma in LUL and cystic carcinoma in LLL
3. Tuberculosis
4. None of the above

Read more…

13
Jun 2016
POSTED BY
DISCUSSION 7 Comments

Dr. Pepe’s Diploma Casebook: Case 92 – SOLVED!

Diploma_casebook_case92

Dear Friends,

Today I am showing radiographs of a 62-year-old man with moderate dyspnoea. No acute symptoms. What do you see?

Check the images below, leave me your thoughts in the comments section, and come back on Friday for the answer.

Read more…

Dr. Pepe’s Diploma Casebook: Case 91 – SOLVED!

Diploma_casebook_case91

Dear Friends,

Today I am showing images of a 48-year-old man with two brain lesions and a pre-op chest radiograph. What would be your diagnosis regarding the chest?

Check the images below, leave your thoughts in the comments section and come back on Friday for the answer.

Diagnosis:

1. Carcinoma
2. Hydatid cyst
3. Pulmonary infarct
4. None of the above

Read more…

Dr. Pepe’s Diploma Casebook: Case 90 – SOLVED!

Diploma_casebook_case90

Dear Friends,

20131011-006-

I am back with a new case, provided by my good friends Paula García and Alberto Villanueva. Images belong to a 52-year-old man with a dry cough. Operated on for cutaneous melanoma ten years earlier. Check the images below, leave us your thoughts in the comments section and come back on Friday for the answer.

Diagnosis:
1. Tuberculosis
2. Metastases
3. Varicella pneumonia
4. Any of the above

Read more…

Dr. Pepe’s Diploma Casebook: Case 89 – SOLVED!

Diploma_casebook_case89

Dear Friends,

This week we are presenting radiographs of a 42-year-old diabetic man with chest pain and fever. What do you see?

Check the images below, leave your thoughts in the comments section, and come back on Friday for the answer.

Read more…