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this is a case that you will encounter as a bit of a common set piece for chest fibers this is a case as you can see over pammi thorax wide out now they seem simple on the surface but theres a lot of extra information that I think can be gained from working through these images and input specially in terms of getting the CT up and being able to come down on a nice clean diagnosis and then I want to wrap up the case quickly so lets say that this is a 65 year old female patient who presents with shortness of breath and cough for the purposes of this case she doesnt have any previous imaging she has not presented to your practice before and we dont have anything to compare to lets also consider that she doesnt have a history of asthma so that the underlying cause isnt going to be something like a mucous plug so having a look at the films we can think about Mass Effect wheres the textbooks tell us to do first so we look to see if the mediastinum is shifted away from the pacified h