Fillers My most valuable lesson

A full examination is always useful

BMJ 2000; 320 doi: https://doi.org/10.1136/bmj.320.7239.923 (Published 01 April 2000) Cite this as: BMJ 2000;320:923
  1. Richard J A Murrin, specialist registrar in haematology
  1. Birmingham

    It happened two weeks ago. One of the patients attending the unit that day was a man who had received an allogeneic stem cell transplant nine months earlier. He presented with a 24 hour history of right sided chest pain which seemed to be temporally related to a recent bout of coughing.

    The patient duly undressed to the waist and I performed a respiratory examination, starting with assessment of chest expansion. My gaze fixed in the direction of my thumbs, I detected no abnormality. Tracheal position central. Tactile vocal fremitus and percussion were normal over the anterior and lateral chest. Auscultation was unremarkable …

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