An 81-year-old man with a remote history of rib and lung resection was noted on examination to have a soft protrusion from the chest wall that moved inward during inspiration and outward during expiration (shown in a video).
Read the full case details in the Images in Clinical Medicine article “Lung Hernia with a Chest-Wall Bulge”: nej.md/4iGMi2l
ALT A photo from the Images in Clinical Medicine article "Lung Hernia with a Chest-Wall Bulge" shows a patient with a visible chest-wall bulge sitting in a hospital room.
Nov 11, 2026 · 11:00 PM UTC
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This is why I still take time with the chest wall exam, even when the chart already has a CT. A soft bulge that moves in with inspiration and out with expiration tells me something a still image can miss, and it changes what I ask about next. In an 81 year old with prior rib and lung surgery, I would want to know how quickly it appeared and whether coughing makes it worse. I will be looking at the video to see how clearly that movement shows up, because that is the detail I would teach a trainee to feel for.
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