Presentation
Cough and shortness of breath. LRTI?
Patient Data
Age: 75 years
Gender: Male
From the case:
Paget disease of the clavicle
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Heart size normal. Lungs clear.
The right clavicle is thickened and sclerotic throughout its length with coarsening of the trabeculae.
No other bone lesion.
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The right clavicle is identical to the prior study.
Case Discussion
This patient has no prior history of malignancy or trauma. This incidental finding was identified on a radiograph performed for respiratory indications.
A few life lessons from this kind of radiograph, and why this may feature in Fellowship exams, such as a discussion case in a viva or rapid reporting examination.
- Periphery of film finding. Will the reporter/candidate identify it?
- Common sense reporting. Rather than suggest other tests or provide a 'hanging' descriptive report, will the reporter review old films?
- Common pathology in a less common location. If this was in the pelvis it would be Paget disease every time.
- Knowing the important differential in an older male patient - metastatic disease from prostate carcinoma.
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