Bilateral Pleural-Based Densities in a Patient with Hip Pain

Abstract

A 55-year-old white woman presented with a twomonth history of increasing dyspnea and dry cough. The week prior to admission, the patient noted the onset of pleuritic chest pain without associated fever, chills, sputum production or hemoptysis. She had no significant occupational exposures, travel or smoking history. Five months prior to admission, the patient had noted mild “arthritic” pain in her right hip which had resolved entirely with aspirin therapy, which she had since discontinued. Physical examination revealed a thin white woman in mild respiratory distress. The blood pressure was 140/80 mm Hg without paradox; pulse rate, 90/mm; respiratory rate, 26/mm; and temperature, 37.5#{176}C. Bilateral dry inspiratory crackles were heard at the bases. Results of cardiac and abdominal examinations were normal. The extremities showed no cyanosis, clubbing or edema. The neurologic exam was entirely normal.