A 60-year-old man presents with chronic cough, worse in the last 2 weeks with new hoarse voice and new left upper limb swelling. He also has mild pleuritic left sided chest pain.
Hugh Spear Pemberton (1890-1956) was an English physician. Pemberton's description of his manoeuvre and Pemberton Sign appeared in a brief letter to The Lancet in 1946
Obstruction of the superior vena cava results from mediastinal mass lesions. Features include a plethoric and cyanosed face with periorbital oedema, exophthalmos, conjunctival injection, and venous dilatation in the fundi, distended non-pulsatile neck veins and a positive Pemberton sign.
Consider a 16 year old who presents with a 3 week history of severe hip pain followed by increasing breathlessness and left sided chest pain. His admission chest X-ray is shown below: