IMAGES IN EMERGENCY MEDICINE
An unusual cause of a pleural effusion
Department of Paediatrics, Musgrove Park Hospital, Taunton, UK
Correspondence to:
Dr R L Boon, Accident and Emergency Department, Hope Hospital, Stott Lane, Salford M6 8HD, UK; robboon69@hotmail.com
Accepted 14 February 2007
| The first 150 words of the full text of this article appear below. |
A normally fit and active 15-year-old schoolboy presented with a 1-week history of productive cough, malaise, fainting, but no fever. He also reported pleuritic chest pain after repeated throwing of a ball 3 weeks previously. An initial diagnosis of pneumonia was made; chest x ray showed a likely parapneumonic effusion and antibiotic therapy was commenced. Full blood count showed haemoglobin 9.8 g/dl, white cell count 11.6 x 109/l, C-reactive protein 8 mg/l. He remained afebrile.
A review of his past medical history revealed a diagnosis of multiple bony exostoses mainly affecting the clavicles, elbows and knees, from the age of 4 years.
Ultrasound-guided aspiration demonstrated blood-stained serous fluid, cytology of which was unremarkable. A computed tomography scan was then performed (fig 1), which demonstrated a 1 cm bony spike on the pleural surface of the sixth rib. A chest drain was inserted and 1500 ml fluid was
CiteULike 
Complore 
Connotea 
Del.icio.us 
Digg 
Reddit 
Technorati What's this?
- Full Text
- Full Text (PDF)
- Submit a response
- Alert me when this article is cited
- Alert me when eLetters are posted
- Alert me if a correction is posted
Services
- Email this link to a friend
- Similar articles in this journal
- Similar articles in PubMed
- Add article to my folders
- Download to citation manager
- Request Permissions
Citing Articles
Google Scholar
PubMed
Topic Collections
-
Pain (neurology)
-
Drugs: infectious diseases
-
Pneumonia (infectious disease)
-
TB and other respiratory infections
-
Pneumonia (respiratory medicine)
Bookmark with
Register for free content
The full back archive is now available for all BMJ Journals. Institutional subscribers may access the entire archive as part of their subscription. Personal subscribers will also have access to all content when logged in. Non-subscribers who register have free access to all articles published before 2006 right back to volume 1 issue 1. Register here to access the free archive of all BMJ Journals.
Don't forget to sign up for content alerts so you keep up to date with all the articles as they are published.
