Can you guess this one?

m.j.fuller · Joined: 14 Mar 2008 Posts: 6

For what it's worth,

- there is irregular spacing of the right ribs re recent surgery
- there is abnormal oapcity over the right hemithorax which crosses normal anatomical lung structures. It is therefore not in the lung or it is secondary to radiation therapy or is a loculated pleural effusion. The fact that the adjacent lateral ribs are slightly lighter suggests that it is not within the thoracic cavity.

- the right hemidiaphragm is slightly elevated which may be of no significance or may represent a subpulmonic effusion.

- the tubular structure visualised above the right scapula is likely to be artifact

- the significance of the right AC joint subluxation is unknown

Best I could do.

Cheers

M.J.FULLER

NB images are OK

Randythetech · Joined: 10 Oct 2008 Posts: 11

Well, from looking at the PA CXR, there is a significant gap between the 5th and 6th ribs, and most definitely a pleural effusion in the R Lungspace, and what seems to be a fluid build around the proximal scapula. I would, as the hypothetical radiologist, want a lateral CXR performed, as well as a R Rib series, both to have a full countdown of the ribs, and to check for possible misalignment superior to the point of interest.

Ultimately, I have a feeling that the Right Scapula infiltrated the Right Lung Replacement, around the area of the 5th/6th ribs.