Case of the Week: Doc, What’s With This Chest Pain?


What is your diagnosis doctor?

History:  A 84yr old gentlemen walks into your office with complaint of chest pain and coughing.  He states he has been battling this “chest cold” for a matter of months. He notes being a chronic smoker for the past 60+ years and had an occupation as a painter.   Today he states having al fever, but nothing that a “few Tylenol” wouldn’t take care of.   He notes having midback pain the area of T3-6 and has been to multiple chiropractors whom all just adjusted him without any further orthopedic/xray/further diagnostic testing.

He states that most recently he notes having issues with deep inhalation and coughing bouts 2-3x per day. He also states walking 2 miles per day.

You decide to have an xray taken and this is what comes back







What is your DDX?   What are you thinking is going on? Please comment below


 Answer to be revealed in the comments