Pseudo-coin lesion due to button

Case contributed by Frank Gaillard
Diagnosis almost certain

Presentation

Pre-op assessment.

Patient Data

Age: 85
Gender: Female
x-ray

Heart and mediastinum are unremarkable. The aorta is somewhat unwound. Rounded opacity projecting in the right medial upper zone appears to be a button on the surface of the patient seen posteriorly on the lateral. The lungs are otherwise unremarkable. Pleural space is clear. Degenerative change both shoulder joints noted, with deficiency of the right rotator cuff.

Case Discussion

It is always important to remember that the outside of a patient is also a source of opacities and care must be taken not to create pathology from buttons, hair-plaits, tubing, shirt folds etc.. 

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