• Andreu Fernández-Codina, Santiago Aranda-Rodríguez, Cleofé Romagosa, Maria Deu-Martin, Carmen Parra-Fariñas, and Segundo Bujan-Rivas.
• Systemic Autoimmune Diseases Unit, Internal Medicine Department, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain; Emergency Department, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain. Electronic address: andreu.fernandez@vhebron.net.
• Chest. 2016 Dec 1; 150 (6): e159-e165.

AbstractA 40-year-old woman consulted our ED for a 7-month history of left dorsal back pain and dyspnea. The pain was initially dull and mechanical. Her general practitioner started nonsteroidal antiinflammatory drugs and physiotherapy, which provided partial relief. One week before consulting, the intensity of the pain increased, and she started to feel shortness of breath when performing her daily activities. She had lost 5 kg during the previous month. The patient was a healthy woman who lived in an urban area of Barcelona, Spain. She did not smoke or take drugs of abuse, and she worked as a butcher. During the initial evaluation, her blood pressure was 131/76 mm Hg, heart rate was 120 beats/min, temperature was 36.2°C, and ambient air pulse oximetry was 98%.Copyright © 2016 American College of Chest Physicians. Published by Elsevier Inc. All rights reserved.

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