Caceres’ Corner Case 132 (Update: Solution)


Dear Friends,

Today we are presenting a PA chest of a 28-year-old woman with fever and pain in the right hemithorax. What do you see? Check the images below, leave your thoughts in the comments section, and come back on Friday for the answer.

PA chest

Click here for the answer to case #132

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    Mar 2016
    DISCUSSION 19 Comments

    19 Responses to : Caceres’ Corner Case 132 (Update: Solution)

    1. Olena says:

      There are no evident changes in soft tissues.
      In the right lung:
      there is peribronchovascular infiltration in prehilar and hilar zones, with light shift of the right hila laterally;
      there is inhomogeneous dicresed lung attenuation in paracardiac region abow the diafragm – infiltration probably in middle lobe (lateral view is needed);
      cardio-diafragmal angle is shadowed because of pleural reaction;
      on the shadow of right atrium it seems like there is a desrtuction – lateral view is needed

      It seems lke there is destructive pneumonia of the right middle lobe, with probable pleural reaction

    2. Borsuk says:

      There is prominent interstitial reticular changes near right hilum I suppose inflammation.
      On the left are two artificial ring-like shadows projecting over lower lung and diaphragm – probably from outside body – I suggest repeat exam without clothes.

    3. Adyarjagadish says:

      Rt lower lobe pneumonitis

    4. murzin says:

      there’s an obvious perihilar infiltration on the right…
      It seems to me that we can also see abnormal right glenohumeral joint- is it possible that the pain is localized laterally?

    5. genchi bari italia says:

      ….sempre controcorrente…..a me sembra che ci siano delle alterazioni osteosclerotiche a carico dell’arco posteriore della 7 costa di dx…se così fosse l’ombreggiatura potrebbe essere di origine muscolo-cutanea per precedenti interventi chirurgici… BARI…un disastro!!!!!

    6. Pasquale rotoli says:

      RIght lower lobe pneumonitis

    7. Mohamed Mourad says:

      right pericardiac pneumonic patch with prominent right hilar shadow

    8. moises botello moreno says:

      Les agradesco por su pagina y sobre todo los casos son de gran ayuda lo felicito y les mando sa ludos des de mexico

    9. sht says:

      Patchy opacity rt perihilar region – consolidation.
      Mild tracheal shift to the right.
      Soft opacity rt paratracheal stripe – not sure whether extending across the midline to the left, but aortic knuckle clearly visible.
      Punctate opacities rt hilum – ?vs/?calcifications.
      A Rt shoulder AP required.

    10. Margaret Cariño says:

      Hello! The lungs are well aerated showing a heterogenous confluence of opacities with apparent few air bronchograms at the area of the right hilum. This may represent consolidation possibly in the superior segment of the right lower lobe. The rest of the lungs are clear. Heart is not enlarged. Great vessels are within normal limits. Diaphragm and sulci are intact. Visualized Ossetia structures are preserved. I suggest lateral view of the chest for better evaluation.

    11. Adam says:

      Pulmonary (right perihilar region) and extrapulmonary (right humeral head) TBC?

    12. Hellene says:

      Let me suppose, osteitis of the glenohumeral joint and humeral head in the right, complicated with septic pneumonia.

      Thanks for each case, dear teacher .

      • Jose Caceres says:

        I believe that the point of this case is detecting the shoulder abnormality. Further evaluation should be done with specific views of the shoulder.
        Well done!