Dr. Pepe’s Diploma Casebook: Case 103 – To err is human: how to avoid slipping up (Chapter 2) – SOLVED!

Dear Friends,

Today I am presenting radiographs of a 30-year-old man. They were taken because an abnormal ECG was found in a routine check-up. What do you see?

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

Click here for the answer

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12 Responses to : Dr. Pepe’s Diploma Casebook: Case 103 – To err is human: how to avoid slipping up (Chapter 2) – SOLVED!

  1. MK says:

    Good morning!!!

    In the lateral view there is an extrinsic compresion of the inferior trachea/left principal bronchus.
    There is a flatened of the left hemidiaghram with a traction of its anterior portion.

  2. Vivi says:

    Hi! in my opinion there is a defect with the big vessels of the heart and their contours. I mean I cannot really separate the borders of aortopneumonic winndow, of the aortic arch and furtheremore I cannot define the whole margin of right pulmonary artery. So, maybe there a displastic aortic arch? or a misposition of vessels and their origin? I would like to see a CT with contrast medium.

  3. Y.E. says:

    I think there is an enlarged right hilum compared to the left one.

  4. UFTM radiogroup says:

    Good morning, professor! Could we say there is an enlargement of right paraspinal line in PA x ray? We think right hilum is not well defined in PA and lateral view. Pulmonary artery anomaly?

  5. Mahmoud says:

    Good evening professor.
    Figure of 3 indentation of aorta and subtle rib notching, suggestive of aortic coarcitation.

  6. Sunita says:

    Coarctation of aorta with rib notching

  7. genchi bari italia says:

    ….l’insegnamento del Professore è quello della DD tra opacità parenchimale o vascolare , alla lettura del radiogramma standard….opacità in sede ilare dx…

  8. Dr Pepe says:

    Congratulations to all of you who said that the right hilum was enlarged, especially Y.E. and UFTM radiogroup, who were the first ones.
    Final answer tomorrow

  9. Dr ahmad al ani says:

    Interesting case and interpretations

  10. Dr. Tareq says:

    a faint round density anterior to the right hilum can be seen on the lateral view, in the mentioned clinical context, i suggest a vascular malformation.


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