Friday, February 20, 2009

xrays

I did a very interesting short case today.... the chest x-ray findings lagi interesting!
take a guess~


11 comments:

  1. from my non-medical background point of view... that looks like a ring of some kind?

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  2. even w medical b/g, i think is sternotomy scar n a ring

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  3. How on earth those thing got there. Can't be a ring.

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  4. i see a ring... with diamond in it... =x

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  5. non-medic point of view:
    swarovski necklace + ring as accessory.

    medically, maybe a sternal suture + artificial valve ?

    oooo...waiting for ur answer...

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  6. good try everyone!! =)

    To my medical friends,
    Lead Wi, you got it right!
    Sing and Endo, almost...

    but, what i'll like to highlight here, is to LOOK BEYOND THE OBVIOUS.... there's is more than one pathology in this patient... if only you look hard enough, you might be able to spot it... ^^

    hint: look at his lungs.

    but of course, in real life, patients don't present with just x-rays per se. We get the benefit of clerking the history and doing physical examination :)
    ----------------------------
    and to the rest, well, considering the option of the patient wearing a necklace with a ring, well, still possible, but usually when taking a PA view xray, patients were asked undress or change into hospital attire, and any necklaces or rings remove...
    and if your were wondering, no, he is unlikely to have swallowed any ring either, as
    1. the esophageal is more centrally located and
    2. the ring would probably appear more O in shape,rather than oblique, as fitting into the flat structure of the esophagus.

    so, in this case, it's not a ring, it's a prosthetic heart valve or artificial heart valve. the lines you see at the central region of the sternum are actually sutures after they had open the ribcage to access the heart..
    but, i kinda like Dann's idea of ring with diamonds :)

    Medical is so amazing... so many can be told just from an xray! don't you think so?

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  7. Impressive! Do share with us more on medical related issue. Its part of the reason why i got this blog tagged. =)

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  8. Left lung collapse
    Ring is artifical valve?

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  9. Dann, glad you liked it!

    Winz, yup! it's an artificial valve. this patient had a lobectomy, part of his left lungs removed... you can see the 'collapsed lung' and the extensive fibrosis.. ^^ very interesting patient for short case... apparently, later on, he came in for our exams.. some of my friends got him ^^

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