March Case of the Month

Access case here.

Authors: Turner K. Fishpaw, MD, PGY1, University of North Dakota, School of Medicine and Health Sciences, Grand Forks, N.D.; Daniel Amirhamzeh, MD, PGY-5, radiology resident, diagnostic radiology, Department of Radiology, Santa Barbara Cottage Hospital, Santa Barbara, Calif.; Laura E. Traube, MD, MPH, attending radiologist, interventional and diagnostic radiology, Department of Radiology; Arthur A. Lee, MD, attending radiologist, vascular and interventional radiology, department of radiology, Santa Barbara Cottage Hospital, Santa Barbara, Calif.; and Bernard Chow, MD, program director, musculoskeletal imaging, Department of Radiology, Santa Barbara Cottage Hospital, Santa Barbara, Calif.

Why did you select this case for submission?

My senior staff steered my attention to this case to illustrate that chest radiographs remain a powerful imaging modality, and to demonstrate how subtle findings and broad differential diagnoses can lead to early identification and treatment of life-threatening pathology.

What should readers learn from this case?

This case should act as a teaching aid for posterior mediastinal masses and as an example of how an aortic aneurysm may present on a chest radiograph.

What did you learn from working on the case?

As my first case submission, the process of selecting representative images and composing a report worth reading was rewarding. Beyond the requisite radiology subject matter, I learned that with enthusiasm, creativity, and willingness to see a project through to completion, even a medical student can coordinate a project that produces an award-worthy case report.

How did guidance from senior staff at your institution impact your learning and case development?

As a visiting medical student at Santa Barbara Cottage Hospital, I was stunned by how supportive and enthusiastic the residents and faculty were when I informed them early in my rotation that I wanted to submit a case report. With no shortage of interesting cases, we quickly identified a case with salient teaching points and subtle, interesting radiological findings. Senior staff experience with academic publication was critical in molding and polishing our final draft.

Why did you choose Case in Point for submission of your case?

All steps of the submission process were streamlined and easy to interpret. I especially appreciate the case suggestion step. Preliminary case approval prior to a full case write-up and submission was crucial, as I had never submitted a case before. Early approval helped confirm that I did indeed have a case worth publishing.

Are you a regular reader of Case in Point? What are your favorite types of cases?

I do read Case in Point regularly. My favorite cases are those that inspire a broad differential diagnosis and effectively keep the reader thinking and second-guessing until close to the end of the case. I also prefer cases that include a variety of imaging modalities.

What else should we know about the case that you would like to share?

I owe the success of this CIP submission to the support and guidance of the incredible faculty and residents at Santa Barbara Cottage Hospital. My rotation with them was an intensive introduction to radiology and they continue to enrich my life as a doctor and a medical learner!

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