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Images in Thorax
Ultrasound for identifying pleural effusion aetiology: have you checked the ribs?
  1. Maged Hassan,
  2. Helen McDill,
  3. John P Corcoran,
  4. Cyrus Daneshvar
  1. Centre for Respiratory Medicine, University Hospitals Plymouth NHS Trust, Plymouth, United Kingdom
  1. Correspondence to Dr Maged Hassan, Respiratory Medicine Department, University Hospitals Plymouth NHS Trust, PL6 8DH, Plymouth, United Kingdom; magedhmf{at}

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Case report

An 88-year-old male inpatient was referred to the Pleural Service with a large left-sided pleural effusion that developed over a 24-hour period. He had a background of ischaemic heart disease and type 2 diabetes mellitus. He had been admitted to hospital 6 weeks prior to this presentation with symptoms of congestive cardiac failure. During that admission, the patient fell onto his left side and a chest X-ray arranged then did not show rib fractures or pleural effusion. Two weeks later, he was readmitted with a presumed pneumonia. On admission, he had bilateral small simple pleural effusions on ultrasound (US) examination. Three days into this admission episode, the patient woke up with excruciating left-sided chest pain. An X-ray (figure 1A) did not show any obvious new abnormality. Within the ensuing day, the chest pain improved but the …

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  • Twitter @magedhmf

  • Contributors All authors treated the patient subject of the report. MH and CD collected the report images. MH drafted the manuscript and CD provided critical revision. All authors reviewed and approved the final version of the manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data availability statement All data relevant to the study are included in the article or uploaded as supplementary information.

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