Copyright © 2009 [Gerald R. Aben, MD MSU Department of Radiology]. All rights reserved.
Revised: April 08, 2009
Review

 

A series of case scenario's are presented below.  

Case 1:  34-year-old alcoholic with a one month history of gradually increasing dyspnea with minimal exercise.  What is the most appropriate chest examination to order?

PA and Lateral
AP
Lordotic
Expiratory film
Left Lateral Decubitus

 Case 1 Image

 

Case 2:    78-year-old patient, smoker with chronic bronchitis experienced a "cold" for 1 week before developing abrupt onset SOB 1 day ago.  This was associated with shaking chills, high fever and rust colored sputum.  What is the most appropriate chest examination to order?

PA and Lateral
AP
Lordotic
Expiratory film
Left Lateral Decubitus

Case 2 Image

 

Case 3:    43-year-old woman with Systemic Lupus Erythematosis complains of a 2 day history of severe, sharp, substernal chest pain which radiates to the left shoulder.  It is associated with fever and worse with deep inspiration. 

AP
Lordotic
Expiratory film
Left Lateral Decubitus

Case 3 Image

 

Case 4:    64-year-old retired foundry worker relates a 3 day history increasing SOB and chest pain. This is associated with fever, shaking, chills and cough with dark brown sputum.

PA and Lateral
AP
Lordotic
Expiratory film
Left Lateral Decubitus

Case 4 Image

 

Case 5:    84-year-old nursing home resident with past history of stroke who presents with non-productive cough and disorientation /confusion.

AP
Lordotic
Expiratory film
Left Lateral Decubitus

Case 5 Image

 

Case 6:    78-year-old man retired serviceman who had spent a number of years in Asia presents with abrupt onset severe chest pain.   What is the most appropriate chest examination to order?

AP
Lordotic
Expiratory film
Left Lateral Decubitus

Case 6 Image

 

Case 7:   55-year-old man with history of chronic bronchitis and gastroesophageal reflux presents with increasing non-productive cough.  What is the most appropriate chest examination to order?

PA and Lateral
AP
Lordotic
Expiratory film
Left Lateral Decubitus

Case 7 Image

 

Case 8:    41-year-old woman with rheumatoid arthritis has a 3 month history of new dyspnea and presents with acute exacerbation of epigastric pain and black stools.

PA and Lateral
AP
Lordotic
Expiratory film
Left Lateral Decubitus

Case 8 Image

 

Case 9:    51-year-old woman raised in Vietnam presents with a 6 month history of nocturnal cough and awaking from sleep, dyspneic.

AP
Lordotic
Expiratory film
Left Lateral Decubitus

Case 9 Image

 

Case 10:    58-year-old woman with 4 years status-post mastectomy for Stage II adenocarcinoma of the breast now treated with Tamoxifen, now presents with present with fatigue and nagging non-productive cough. 

AP
Lordotic
Expiratory film
Left Lateral Decubitus

Case 10 Image

 

Case 11:    A screening chest radiograph on admission to a nursing home. What is the most appropriate chest examination to order?

AP
Lordotic
Expiratory film
Left Lateral Decubitus

Case 11 Image

 

Case 12:    38-year-old male with AIDS, anorexia, weight loss and low grade temperature.

AP
Lordotic
Expiratory film
Left Lateral Decubitus

Case 12 Image

 

Case 13:    35-year-old homosexual male presents with sub-acute onset of dypnea and cough. What is the most appropriate chest examination to order?

AP
Lordotic
Expiratory film
Left Lateral Decubitus

Case 13 Image

 

Case 14:    28-year-old with Crohn's Disease treated with chronic prednisone and inflixamab infusions with recent acute onset midline back pain. What is the most appropriate chest examination to order?

AP
Lordotic
Expiratory film
Left Lateral Decubitus

Case 14 Image