Original case by Lauren Brown, MD.
Graphics by Yilin Zhang, MD.
- Narrow the differential of opacified hemithorax based on tracheal deviation
A 72 yo W with recently diagnosed metastatic renal cell carcinoma presents with 1 week of increasing shortness of breath and nonproductive cough. On exam is she afebrile, tachycardic to 110s, RR 22, 96% on RA. She has absent breath sounds in the R hemithorax.
What is your differential for an opacified left hemithorax?
TAKE HOME POINTS
- Look at the deviation of the trachea to narrow the diagnosis of an opacified hemithorax (aka “total lung white out”).
**Click here for the full clinical case version of this vignette (~10-15 min) that contains additional teaching points on her final diagnosis.