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History of difficulty walking of several months duration, right hind leg is worse.
Physical Exam: grade 5 or 6 murmur, left sided mitral. Radiographs done for pre-anesthesia met check; concerned about possible mass in chest.
History of difficulty walking of several months duration, right hind leg is worse.
Physical Exam: grade 5 or 6 murmur, left sided mitral. Radiographs done for pre-anesthesia met check; concerned about possible mass in chest.
Rads of right lateral, left lateral and VD thorax – Osseous structures: There were minor incidental degenerative changes associated with the axial skeleton as included in the images.
Extrathoracic soft tissue structures: within normal limits.
Intrathoracic structures: The course of the trachea was normal. There was an incidental redundant tracheal membrane level with the thoracic inlet on one of the lateral views. There was no mediastinal widening. The size and shape of the cardiac silhouette were within normal limits. The major vessels and pulmonary vessels were within normal limits. Currently there were no signs of congestive heart failure.
There was an ovoid shaped, well delineated soft tissue opaque nodule associated with the pulmoary parenchyma superimposed onto the cardiac silhouette, which was well visible on the right lateral and faintly visible on the left lateral view.
A mild generalized age related incidental bronchointerstitial pattern was noted.
Depending on the clinical question in this patient tumor staging including abdominal ultrasound and regional lymph node exam should be recommended.
Note that the minimum size of nodules recongnizable on radiographs is approximately 5-7 mm under ideal conditions. If indicated pulmonary CT offers a higher accuracy regarding number and size of interstitial lung nodules.
The views were obtained in moderate inspiration. The views were available in jpeg format; DICOM would be the preferred format for unlimited postprocessing.
