The patient's wife posted this image in the whatisit subreddit, where I learned that this is a modern xray marker. I spent 30 years reviewing chest xrays, and back in the previous century the xray markers were less elaborate. Classically the orientation was indicated with a lead "R" or "L" (or full word "LEFT") -
- sometimes with a movable pellet inside to indicate upright, supine, or decubitus positioning...
Nowadays apparently the standard is to have the xray technician's initials incorporated into the marker, which the technician can (?has to) buy from sites like Etsy -
You learn something every day - even stuff you thought you knew.
Scoliosis in the first xray?
ReplyDeleteMounier-Kuhn syndrome (congenital tracheobronchomegaly). You can see the huge sizes of the right and left mainstem bronchi. After decades of poor clearance of secretions and recurrent pneumonias, the fellow developed bronchiectasis and scarring in the RLL, which pulled the mediastinum to the right. It's a good example of why the position markers are useful, because otherwise the reflex would be to put this film up on the viewbox reversed.
Deletehttps://journals.lww.com/thoracicimaging/abstract/1991/04000/congenital_tracheobronchomegaly__mounier_kuhn.3.aspx
The discussion and images at the link will be behind a paywall, but you can view the abstract (and the identity of the senior author...)