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70years female, pain in right side of chest from 2days. Chief Complaints Right side chest pain. Vitals BP 120/80 mm/ hg. Puls 78 bpm Tem. 97.5°F Investigations Chest X-RAY Diagnosis Please suggest Management Please suggest

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Cannonballs opacities seen in lt hilar rt paratracheal and retrocardiac lt side Round big opacity extrapulmonary in axillary area rt side Suggestive of secondaries /metastasis Axillary swelling may be mets or primary PANCOSTS TUMOR since pt is female look for uterine or cervical 9r ovarian primaries

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Rt paratracheal opacity seen possibly, superior mediastinal widening. Parahilar opacities seen. Adv HRCT thorax.

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Bilateral hyperinflated lungs Right paratracheal smooth oval opacity Thin line of air along right cardiac border and chest wall ? Mediastinal and surgical emphysema . Suggest ECHO and CT chest

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Poorly exposed Image Aortic knuckle calcification Cardiomegaly Get 2D echo or ECG Repeat Digital xray with interpretation

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Likely cardiomegaly, calcified aortic knuckle with emphysema

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Cardiomegaly seen

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Perform an ECG and trop T test

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