Dear Friends,
Now that Game of Thrones is ending, a new series is planned: Game of Thorax, in which either you diagnose or you die.
As you can see in today’s radiograph, the Iron Throne has been replaced by the Chest Throne.
What would your diagnosis be?
Come back on Friday to see the answer.
Click here to see the answer
Findings: PA chest radiograph show numerous metallic wires spread fan-like throughout the upper two thirds of both lungs.
This appearance is typical of endobronchial coils for lung volume reduction in patients with emphysema. They are used when other therapeutic alternatives are not feasible or as a bridge to lung transplantation.
I am showing this case because I have never seen one and wanted to share it with you. And to complain about the last season of Game of Thrones, of course!
Congratulations to all of you who made the diagnosis, led by MK, who was the first.
Good morning!!
Here Daenerys
Emphyseamtous thorax. There are lot of foreign bodies (valves for treating pulmonary emphysema).
I would not consider a wise choice calling yourself Daenerys nowadays 🙂
Bronchial artery embolization for hemoptysis/ endometriosis
You die. Sorry 🙂
Extensions
greetings professor
these are endobronchial coils/valves inserted for lung volume reduction.
both diaphragmatic silhouette appears ill-defined. both hemidiaphragm are flattened suggesting previously emphysematous lungs .
nodular opacity in right lower zone, warrants comparison with previous radiograph or repeat radiograph after BB marker.
right heart border is obscured and there are atelectatic opacities adjacent to it, could be atelectasis of right middle lobe —lateral xray would be helpful.
there is also an suggestion of bulla in right lower zone causing impression on right heart border.
Pulmonary AVMs or pulmonary vasculitides (for example Wegener granulomatosis)
Multiple surgical coils / wires for treatment of vasculitides