Monthly Archives: April 2018

CT Scans

On January 5, 2017 I fell. I don’t know what happened, but I obviously wasn’t paying attention and fell backward against the air vent for my heating oil filler. I fell so hard, I moved it:

The scene of the fall

I fell against the heating oil filler air vent and moved it off vertical.

At first I just thought I was having muscle spasms so I took Flexeril and went to bed. Pain didn’t subside and I felt bones moving, so I expected I had broken a rib. I went to the local emergency room three days after the fall and their first question was: “What took you so long to get here?” I had no good answer to that.

Anyway, they did a CT scan and confirmed I had broken three ribs with no displacement. They gave me a Percoset and sent me home, telling me to take it easy. I asked for and got a DVD containing the CT scan data. You can download software to look at a CT scan on your computer, believe it or not, but I could just barely make out the break in one rib.

I sent the DVD to my primary care physician in Boston and she sent it on to the radiology department there for a reading. Here’s their report:

Lines/tubes: None.
Lungs and Airways: The central airways are patent. Calcified granuloma seen in
the right upper lobe. Bilateral lower lobe patchy dependent consolidations are
seen. There is mild emphysema.
Pleura: The pleural spaces are clear.
Heart and mediastinum: The visualized thyroid gland appears atrophic. The
ascending aorta is aneurysmal and measures 4.1 cm. There is mild multichamber
cardiomegaly. No pericardial effusion is seen. A small hiatal hernia is seen.
The esophagus is patulous. No mediastinal or hilar lymphadenopathy is seen.
Soft tissues: No enlarged axillary or subpectoral lymphadenopathy.
Abdomen: Lack of intravenous contrast limits evaluation of the intra-abdominal
organs. Cholelithiasis is seen without gallbladder wall thickening or
pericholecystic fluid. A 1.5 cm fat-containing lesion is seen within the
pancreatic body, and likely represents an incidental lipoma. The remaining
visualized upper abdomen is unremarkable. Scattered colonic diverticulosis is
seen without evidence of acute diverticulitis.
Bones: There are degenerative changes. No suspicious lytic or blastic lesions.
There are healed right sided rib fractures.
Patulous esophagus with bilateral lower lobe dependent patchy consolidations
which may represent a combination of atelectasis, aspiration or pneumonia.
Aneurysmal ascending aorta measuring 4.1 cm.
RECOMMENDATION: Follow up chest CT in 6-8 weeks.

They made no mention of my broken ribs on my left side! I called my PCP and said this can’t be me! I don’t have an aneurysm. I don’t have emphysema. I don’t remember breaking any ribs on my right side. And this guy has no broken ribs on his left side!

My PCP was sure it was me and started testing me to confirm the aneurysm and my esophagus and stomach problems. She also asked the radiology department to have another look. They added this addendum to my report:

There are subtle fractures involving left 9, 10 (posterolaterally), and 12th
ribs (posteromedial end) which are non-displaced. There is mildly displaced
fracture involving the posterior aspect of the left 11th rib.
Because findings in this report may be important, an automated tracked email
will be sent to the referring physician upon report finalization by the
attending Radiologist

Anyway, the emphysema and aneurysm will be watched and I will continue my GERD precautions. (That’s another story.)

So the bottom line is if the radiologist is just checking for broken ribs, that is what he/she finds. But if they’re just asked to look at a CT scan, they find all kinds of stuff.

I have also added railings to those steps:

New railings

New railings installed with the help of my grandson, pictured.