A full examination is always useful

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 …