Hello. My name is Jack Henry, DC, DACBR. I am Radiologist-in-Chief of
Radiology Diagnostics, LLC, an industry leader of Chiropractic Radiology Services and Digitized Spinographic analyses. All of our services are provided at no cost to doctor and no/low cost to patients.
Selected cases will be presented for your evaluation. The studies may or may not have abnormalities. Use the arrow keys or the scroll bar to carefully evaluate the films.
Step 1: Is the study abnormal or normal?
Step 2: If the study is abnormal, what is your best diagnosis?
Step 3: Which follow-up imaging option would be best?
Step 4: Compare your results with the correct diagnosis.
HISTORY
A 52-year-old female reports neck stiffness of three weeks duration. No history of trauma was reported. The patient’s past medical history and physical examination were relatively unremarkable.
FINDINGS
The study is negative for acute fracture or dislocation. The cervical contour is flat. There is no significant osseous or joint abnormality present. Please note the convex soft tissue density projected over the right apical lung field on the APLC image. The adjacent ribs appear uninvolved at this time.
DISCUSSION
This expanding soft tissue lesion represents an extrapleural sign. This lesion most likely resides within the chest wall or parietal pleura. Remember the mediastinum is extrapleural as well. Note the peripheral location and characteristic shape of the mass. Unfortunately for this patient, METS must be excluded, all other considerations are subordinate.
FOLLOW UP PROTOCOL
A CT evaluation is recommended.