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  1. X-ray (chest), AP, Adult Male, Thoracic Bullet, Annotated

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    Description: CXR AP and Lat - Adult male, thoracic bullet 1. Foreign body, more radio opaque than bone, consistent with a metallic object such as a bullet. It is unclear if this object is located within the thoracic or the abdominal cavity. Addition of the lateral view shows the bullet lies either deep within the posterior chest cavity or in the paraspinous musculature. 2. Curved, meniscus-shaped blunting of the left costophrenic angle consistent with pleural effusion. If this study was obtained in the setting of acute trauma then this finding would most likely represent an acute hemothorax and indicate the placement of a chest tube during ED stabilization. Also a bedside ultrasound to check for pericardial effusion would be very useful and potentially lifesaving. Note there is no evidence of pneumothorax: lung markings can be seen all the way to the periphery of both lungs. Also, if there were a hemo-pneumothorax on the left the pleural fluid would layer with an air-fluid level, not be meniscus-shaped.
    Keywords: Diagnostic X-Ray, Radiography, Thoracic, Bullet, Roentgenography, Wounds and Injuries, Radiology, Diagnostic X-Ray, Diagnostic X-Ray Radiology, Foreign Bodies, X-Ray, Diagnostic, Diagnosis, X-Ray Radiology, Diagnostic

  2. X-ray (chest), LAT, Adult Male, Thoracic Bullet

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    Description: CXR AP and Lat - Adult male, thoracic bullet 1. Foreign body, more radio opaque than bone, consistent with a metallic object such as a bullet. It is unclear if this object is located within the thoracic or the abdominal cavity. Addition of the lateral view shows the bullet lies either deep within the posterior chest cavity or in the paraspinous musculature. 2. Curved, meniscus-shaped blunting of the left costophrenic angle consistent with pleural effusion. If this study was obtained in the setting of acute trauma then this finding would most likely represent an acute hemothorax and indicate the placement of a chest tube during ED stabilization. Also a bedside ultrasound to check for pericardial effusion would be very useful and potentially lifesaving. Note there is no evidence of pneumothorax: lung markings can be seen all the way to the periphery of both lungs. Also, if there were a hemo-pneumothorax on the left the pleural fluid would layer with an air-fluid level, not be meniscus-shaped.
    Keywords: Roentgenography, Thoracic, Bullet, Wounds and Injuries, Radiography, X-Ray, Diagnostic, Radiology, Diagnostic X-Ray, X-Ray Radiology, Diagnostic, Diagnostic X-Ray Radiology, Diagnostic X-Ray, Diagnosis, Foreign Bodies

  3. X-ray (chest), LAT, Adult Male, Thoracic Bullet

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    Description: CXR AP and Lat - Adult male, thoracic bullet 1. Foreign body, more radio opaque than bone, consistent with a metallic object such as a bullet. It is unclear if this object is located within the thoracic or the abdominal cavity. Addition of the lateral view shows the bullet lies either deep within the posterior chest cavity or in the paraspinous musculature. 2. Curved, meniscus-shaped blunting of the left costophrenic angle consistent with pleural effusion. If this study was obtained in the setting of acute trauma then this finding would most likely represent an acute hemothorax and indicate the placement of a chest tube during ED stabilization. Also a bedside ultrasound to check for pericardial effusion would be very useful and potentially lifesaving. Note there is no evidence of pneumothorax: lung markings can be seen all the way to the periphery of both lungs. Also, if there were a hemo-pneumothorax on the left the pleural fluid would layer with an air-fluid level, not be meniscus-shaped.
    Keywords: Diagnostic X-Ray Radiology, Thoracic, Bullet, Foreign Bodies, Radiology, Diagnostic X-Ray, Roentgenography, Diagnostic X-Ray, Diagnosis, X-Ray, Diagnostic, Wounds and Injuries, X-Ray Radiology, Diagnostic, Radiography

  4. X-ray (chest), AP, Adult Male, Thoracic Bullet, Annotated Answers

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    Description: CXR AP and Lat - Adult male, thoracic bullet 1. Foreign body, more radio opaque than bone, consistent with a metallic object such as a bullet. It is unclear if this object is located within the thoracic or the abdominal cavity. Addition of the lateral view shows the bullet lies either deep within the posterior chest cavity or in the paraspinous musculature. 2. Curved, meniscus-shaped blunting of the left costophrenic angle consistent with pleural effusion. If this study was obtained in the setting of acute trauma then this finding would most likely represent an acute hemothorax and indicate the placement of a chest tube during ED stabilization. Also a bedside ultrasound to check for pericardial effusion would be very useful and potentially lifesaving. Note there is no evidence of pneumothorax: lung markings can be seen all the way to the periphery of both lungs. Also, if there were a hemo-pneumothorax on the left the pleural fluid would layer with an air-fluid level, not be meniscus-shaped.
    Keywords: Diagnostic X-Ray Radiology, Bullet, Diagnostic X-Ray, Wounds and Injuries, Roentgenography, Radiology, Diagnostic X-Ray, Thoracic, X-Ray, Diagnostic, Diagnosis, Radiography, X-Ray Radiology, Diagnostic, Foreign Bodies