Posted By Robert Smith, MD Associate Professor of Medicine, Division Pulmonary and Critical Care Medicine
The patient is a 77 year old male whose chief complaint was severe left hip pain of five years duration. As part of a preoperative evaluation for hip surgery, a routine chest x-ray was obtained as below. Click on the thumbnails below for full size images:
A prior film done six months previously showed similar but less impressive findings. Upon review, the patient denied any pulmonary symptoms or significant history of smoking. There was no history of pets, occupational exposures, recent travel or illicit drug abuse. His only medication was oxcodone.
Chest computed tomography showed the following:
What procedure would you recommend and what is your preprocedure diagnosis?
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