Correct!
3. Repeat chest radiography
The clinical history suggests the possibility of an acute lower respiratory tract infection and the recent chest radiograph is non-specific, but at least not unsupportive of this working diagnosis. As the main clinical concern is pulmonary parenchymal infection, thoracic MRI plays no role in the evaluation of this patient. The role of 18FDG-PET scanning is largely limited to the evaluation of indeterminate solitary pulmonary nodules and staging of primary lung, pleural, and esophageal malignancies, or assessment of suspected metastatic disease in the setting of extrathoracic neoplasia, and is generally not employed in the setting of suspected acute infection. Percutaneous transthoracic needle biopsy is typically utilized to target solitary or multiple pulmonary nodules, or pleural or chest wall lesions, for tissue sampling, and no such target is available in this circumstance. Ventilation-perfusion scintigraphy is most often used to assess patients for suspected venous thromboembolism, and so could play a role in the assessment of a patient with thoracic symptoms associated with an as yet unconfirmed non-thromboembolic etiology for those symptoms, but the absence of thromboembolic risk factors and the patients presenting complaints point more towards lower respiratory tract infection rather than pulmonary embolism; therefore, repeat chest radiography is the most appropriate choice of those listed above.
Repeat chest radiography (Figure 2) was performed.
Figure 2. Panel A: Repeat frontal chest x-ray. Panel B: Repeat lateral chest x-ray.
Which of the following statements regarding the chest radiograph is most accurate? (Click on the correct answer to proceed to the next panel)