Case 2
Using the ABCDE system, (A-airway, B-bones, C-cardiomediastinal, D-diaphragm, E-everything else), decide which area is abnormal in this case.
Question 1:
a) What are possibilities for the abnormality on this image?
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Answer:
There are diagonal stripes of abnormal density across both sides of the chest. While they could involve the pleura, the distribution suggests that they are abnormal ribs. This could represent rib expansion from metastasis, fibrous dysplasia, or marrow expansion.
There are diagonal stripes of abnormal density across both sides of the chest. While they could involve the pleura, the distribution suggests that they are abnormal ribs. This could represent rib expansion from metastasis, fibrous dysplasia, or marrow expansion.
b) What additional imaging would be indicated?
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Answer:
The answer depends on the clinical setting. At least a lateral chest radiograph should be performed, but if metastasis is considered, a bone scan or PET imaging study might be indicated. If other lab values suggest a specific diagnosis, no additional imaging may be needed.
The answer depends on the clinical setting. At least a lateral chest radiograph should be performed, but if metastasis is considered, a bone scan or PET imaging study might be indicated. If other lab values suggest a specific diagnosis, no additional imaging may be needed.
