A young patient in his 30s came to my OPD with sudden shortness of breath.
He was very tachypnic, so I ordered an urgent xray
And here it is
In this patient most likely cause could have been a central bronchial neoplasm causing narrowing of the upper lobe bronchus with consequent infection given his family history
A primary pneumonia remained a possibility and so was the clinical presentation which helped in determining whether conservative treatment with radiological follow up was a better option than referral for bronchosopy.
We went with appropriate conservative management and he is back to normal
PS (For Med students) :
This is a PA chest radiograph
The film is not rotated and there is adequate inspiration.
A: The trachea is central.
B: The lungs are uniformly expanded. There is right upper lobe collapse/consolidation (increased density of the right upper zone, elevation of the horizontal fissure and loss of definition of the upper right mediastinal margins)
C: The heart size is normal. There is no mediastinal shift. The mediastinal contours and hila appear normal.
D: There is no fracture or bony abnormality.
E: There is no evidence of air under the diaphragm, surgical emphysema or any foreign body.
In summary, this is an abnormal chest radiograph showing right upper lobe collapse/consolidation.
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