Skip to main content
Chronic Pain in the Lower Rib Cage – Suspected Intercostal Neurinoma

67-year-old male began to complain of chronic pain in the left lower rib cage. The pain is stitch, ever-present, dull and localized at the level of his left last rib, and became slightly worse in the last 2 years. Recent image findings: MRI - "Ovalish hypoechogenic solid formation, Ultra sound - "Suspected intercostal neurinoma at ribs 10, 11 and 12.

Valvular Heart Disease in Dissection of the Ascendant Aorta and Abdominal Aortic Aneurysm

72-year-old male with a diagnosis of mitral valve prolapse and chronic severe mitral regurgitation, aortic root and ascending aorta dilatation and patent foramen ovale. On 06/2008 he had dissection of the descending aorta. The clinical course has been characterized by hemodynamic stability and the vascular surgeon decided on conservative treatment and follow–up by thoracic CT.

Sinus Tachycardia in Mitral Insufficiency

43-year-old female with history of continued cigarette smoking and complaints of palpitations. A sinus tachycardia of 160 is documented with little physical activity. Pulmonary function studies revealed obstructive ventilatory defects, consistent with the smoking or beta blockers. She has been documented to have moderate mitral regurgitation, consistent with prior rheumatic disease. At the present time, she is on Inderal.

Metastatic, Non Small Cell Lung Cancer

67-year-old with multiple co morbities: Heart, renal, vascular, hypertensive. His biopsy showed left lower lobe lung mass that was a TTF-1 Non small cell lung cancer- most likely an adenocarcinoma. Multiple small nodules < than 1cm were noted without certain etiology, together with “masses” in the upper abdomen and left arm. Recommended therapy includes single agent Vinorelbine.

Metastatic, Non Small Cell Lung Cancer – further opinion

67-year-old with multiple co morbities: Heart, renal, vascular, hypertensive. His biopsy showed left lower lobe lung mass that was a TTF-1 Non small cell lung cancer- most likely an adenocarcinoma. Multiple small nodules < than 1cm were noted without certain etiology, together with “masses” in the upper abdomen and left arm. Recommended therapy includes single agent Vinorelbine.

Juvenile Arthritis with Systemic Onset (Stills Disease)

50-year-old male was diagnosed with Juvenile arthritis with systemic onset (Stills disease) after having symptoms of high fever, rashes and pain. He was treated with high doses of corticosteroids, but had two exacerbations in the last 2 years. In the current time he suffers of swelling of knee joints and hand joints, and occasionally a feeling of burning feet or cold feet. In the expert's opinion, the clinical description fit well with the diagnosis of adult onset systemic arthritis which manifestations are similar to the juvenile systemic arthritis.

Left Ventricular Dysfunction and Aortic Stenosis

62-year-old female with systolic heart murmur for 6 years. Her first echocardiogram showed mild to moderate LV dysfunction with regional wall motion abnormality. The second echocardiogram the left ventricular function was interpreted as normal, there was left ventricular hypertrophy and severe aortic stenosis. The expert recommends to perform another third echocardiogram. If the patient has truly left ventricular function and severs aortic stenosis then aortic valve replacement surgery is recommended, even if she is asymptomatic.