Dear friends,
Today’s PA radiograph belongs to a 46-year-old woman pre-op for plastic surgery. Check the image below, leave your thoughts in the comments section and come back on Friday for the answer.
Diagnosis:
- Healed TB
- Rib osteochondroma
- Lung hamartoma
- None of the above
Click here for the answer
Findings: PA radiograph shows numerous pointed opacities projected over the right upper lung (A, circle). They are denser than the ribs, which is a clear indication of artifacts. Close examination of the right apex shows a tubular shadow that extends into the soft tissues of the neck (A, arrows), suggesting a hair braid. The patient was examined, and a ponytail rubber holder was removed (insert). After removal, the chest presents a normal aspect (B).
Final diagnosis: ponytail holder simulating a pulmonary lesion.
Congratulations to MK, who was the first to suggest the correct diagnosis. And my appreciation to Ren and Mauro for cooperating with the blog.
Teaching point: remember that opacities in the upper lungs may be related to hair implements. I saw recently another case of a braid holder thought to be a foreign body by the paediatrician (C, arrows).
Good morning!!!
There are some high density points proyected over the right sterno-clavicular articulation, and there is an increased density in the soft-tissues of the latero-cervical region so…… Something external to the patient, perhaps she has a fashion rubber band!!!!
Right paratracheal packet with associated high densities projected over the anterior end of right 1st rib
1 Articulation of sternoclavicular joint
2 braid artefact
Hello.
None of the above, I think this is either a film artefact or something external to the patient.