Spends too long considering quality
Does not mention hyperexpansion
Ignores the bone abnormalities
Demonstrates systematic approach
Mentions hyperexpansion and explains its relevance (obstructive lung disease)
Mentions the bone abnormalities and attempts to explain them
Fluently describes radiological features and explains all physical signs and symptoms
Offers a coherent summary of the clinical and radiological findings
This OSCE station tests the candidate's ability to put together clinical and radiological features.
The X-ray shows signs of emphysema. This is also evident in the history.
Chest pain and point tenderness is easily explained by the multiple rib fractures evident on the X-ray
Clinical details such as drug history may seem irrelevant at first, but should not be ignored. Steroid treatment for obstructuve pulmonary disease has led to reduced bone density with resulting multiple rib fractures secondary to trivual trauma, in the form of coughing.