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

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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

Xrays:

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

 

 Answer to be revealed in the comments

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