Prostatic bony metastatic disease

Case contributed by Dr Ian Bickle

Presentation

Prostate carcinoma (not mentioned on request). Breathlessness. Infection?

Patient Data

Age: 70 years
Gender: Male
X-ray

The whole of the visualised skeleton is dense, with some more discrete sclerotic foci such as in the humeri.

Lungs clear.

Case Discussion

A few learning points from this plain radiograph:

1. Clinical information: this is not always forthcoming, but being able to interpret in its absence is an even better skill. Use historical imaging to help: prior studies (especially bone scans or CT) may be able to help confirm your suspicions.

2. Diffusely abnormal things are harder to notice. The eyes are often drawn to asymmetry.

3. Don't waste expensive resources: try to give a definite report and use the information available to you to assist. Don't send the patient for more tests with a differential for sclerotic bones when the answer can be found elsewhere.

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Case information

rID: 56523
Published: 9th Nov 2017
Last edited: 9th Nov 2017
System: Chest
Inclusion in quiz mode: Included

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