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The thoracic or rib cage forms the body's thorax (chest) portion. Its primary function in the body is to protect vital organs in the thoracic cavity, such as the heart and the lungs. It consists of 12 pairs of ribs with their costal cartilages and the sternum. The ribs are anchored posteriorly to the 12 thoracic vertebrae (T1-T12).
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A "Galactic" Chest X-ray.

Cristiano Carbonelli1, Angela de Matthaeis2, Antonio Mirijello2

  • 1Unit of Pneumology, Department of Medical Sciences, IRCCS Casa Sollievo della Sofferenza, 71013 San Giovanni Rotondo, Italy.

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The "galaxy sign" on chest X-ray, indicating diffuse lung involvement, can mimic COVID-19 but suggests other diagnoses like sarcoidosis or tuberculosis. Endoscopic techniques may confirm these conditions.

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Area of Science:

  • Pulmonology
  • Radiology
  • Infectious Diseases

Background:

  • Respiratory failure presents with non-specific symptoms like cough, dyspnea, and fever, complicating diagnosis.
  • The COVID-19 pandemic necessitates efficient diagnostic methods to reduce hospital strain.
  • Radiological patterns are crucial for guiding clinical and laboratory workups.

Purpose of the Study:

  • To highlight a specific radiological pattern, the "galaxy sign," in a suspected COVID-19 case.
  • To discuss the differential diagnoses suggested by this pattern.
  • To emphasize the role of endoscopic techniques in confirming diagnoses.

Main Methods:

  • Case report of a 58-year-old female admitted for suspected COVID-19.
  • Analysis of chest X-ray findings revealing diffuse, alveolar, and interstitial lung involvement with coalescing micronodules.
  • Consideration of differential diagnoses based on the "galaxy sign" radiographic pattern.

Main Results:

  • The patient presented with dyspnea, tachycardia, and fever.
  • Chest X-ray showed a "galaxy sign" pattern, characterized by diffuse, coalescing nodular miliary lung involvement.
  • This pattern is typical for sarcoidosis, tuberculosis, pneumoconiosis, or metastatic lesions, and atypical for viral pneumonitis.

Conclusions:

  • The "galaxy sign" is a significant radiographic finding that can mimic COVID-19 but points towards other serious pulmonary conditions.
  • Radiological interpretation is vital for differentiating causes of acute respiratory failure.
  • Endoscopic procedures are valuable for definitive diagnosis and targeted treatment initiation.