Hola amigos, hoy os presento una radiografía de tórax en un hombre de 57 años con fiebre.
¿Cuál sería vuestro diagnóstico?
Podéis dejar vuestro comentario hasta el viernes, día en que se dará la solución.
Haz click aquí para ver la respuesta
Hallazgos: La radiografía PA de tórax muestra una discreta elevación del hemidiafragma derecho, de aspecto inespecífico. El hallazgo más sobresaliente es la presencia de aire en los tejidos blandos del hombro izquierdo (A, círculo). Una radiografía localizada de hombro muestra aire articular (B, flechas) y en tejidos blandos de pared torácica.
Diagnóstico final: Artritis infecciosa de hombro con formación de gas.
Felicidades a Aloria, que sugirió el diagnóstico correcto.
Teaching point: Es importante mirar las cuatro esquinas de la placa. A veces, se descubren anormalidades significativas como en el caso presentado.
Tuberculosis
Elevaciòn de hemidiafragma derecho: Derrame subpulmonar v/s Abceso Hepàtico
left shoulder arthritis?
probably gynecomasty
Right phrenic nerve palsy, mediastinal widening… mediastinal mass? aortic aneurysm?
…llama la atención la elevación del hemidiafragma derecho, en nuestro medio es conveniente descartar un absceso subfrénico. Algún otra imagen para agregar???? Veremos el viernes…
Creo que la mayoría se ha dejado llevar por la primera impresión y no ha mirado las cuatro esquinas de la radiografía. Recordad que hay que evitar la “satisfaction of search”
Artritis séptica del hombro izquierdo
Air in the projection of the left scapula- axillary abscess?
Based on the observation of a region with lower density and distinct angles of contact, it is more probable that the condition is hemangiopericytoma rather than meningioma. However, the increase in contrast may suggest the presence of hemangiopericytoma.
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