Imaging Case of the Week 559 Answer

The chest x-ray is technically inadequate.

AP view has magnified the cardiac shadow. There is increased lucency over the left lung field, but the x-ray is rotated. The costo-phrenic recess and part of the diaphragms are missing.

Despite technical faults, a subtle but important finding is that the right humeral head is out of its socket, indicating the presence of a right sub coracoid dislocation.

The patient had a dedicated right shoulder x-ray which showed an anterior dislocation of the right shoulder which was subsequently reduced.

ABCDEFGHI method of chest x-ray interpretation (got off internet) can avoid errors.

A – Airway – trachea and main bronchi.

B – Bones & joints.

C – Cardiac shadow.

D – Diaphragms.

E – Effusion

F – lung Fields

G- Gastric bubble.

H – Hilum

I – Interpretation