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Radiological Quiz Series- CXR- Winners to be featured here.

Here is another case, a CXR, for your opinion what are the findings and possible diagnosis? What investigations do you want to see now? We will be uploading the answer and confirmatory studies soon. Please submit your answer in the comment section with full name to be featured here.

Winners - None, no one gave this even in the differentials

Answer: Pectus excavatum:  the sternum is depressed so that the ribs on each side protrude anteriorly more than the sternum itself. Posteroanterior radiograph depicts an area of increased density in the inferomedial portion of the right hemithorax. Along with blurred right cardiac border and displacement of heart towards left. CT images confirming the diagnosis are also provided. 

Radiological Quiz Series- CXR- Winners to be featured here. Reviewed by Sumer Sethi on Monday, January 23, 2012 Rating: 5


imuwithash said...

Bilateral Reticulonodular opacities with Hyperventilated lung fields !
Blunting of right CP angle ? Thickening ?? Effusion !
HRCT advised for both reticulonodular and For effusion confiramation Lateral decubitus ?
ILD / Malignancy ?

Dr Vineet Marwaha said...

Cardiac apex is shifted superiorly, suggesting right ventricular hypertrophy. ECHO suggested.

mitesh said...

elevated cardiac apex..
right ventricular hypertorphy..

rishu said...

mediastinal widening in bilateral lower paratracheal region.

Ashraf el masri said...

Elevated apex of the heart denoting right ventricular hypertrophy , enlarged main pulmonary artery segment with pulmonary plethora denoting pumonary vavlve stenosis

it the patient is achild and non cyanotic i will suugest VSD with left to right shunt

Pankaj Nagori said...

Sir, first of all it looks like a scout of CT so likely a confirmatory CT has been done. The scout reveals upturned cardiac apex, widened carinal angle (~90 degree) and prominent aorta - Next investigation should be a Echo which would help in diagnosis. Possible diagnosis - ?TOF/ ? Pulmonary hypertension/ ?Dilated right ventricular cardiomyopathy.

sankar said...

mediastinal widening with blunting of right cp agle. laterL film will help more.

sankar said...

mediastinal widening with blunting of right cp angle. upturned cardiac apex. a lateral film will help more, followed by echo.

divyanka srivastava said...

widening of anterior mediastinum
cardiomegaly with left ventricular enlargemnt
ADV Cardiac CT

Dr.Abhishek Bansal said...

Dear Sir,

Can we see a zoomed in version of the scan to adequately look at the lung fields?

Wael Nemattalla said...

Congenital pericardial defect.

No pulmonary plethora to suggest Fallot.

Dinn said...

PECTUS EXCAVATUM, Cardaiomegaly is a result of Reduced AP dia of Thorax

Dinn said...

PECTUS EXCAVATUM, Cardiomegaly is a result of reduced AP Diameter - MVP.The heart can be displaced and/or rotatedBase lung capacity is decreased

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