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ENDGAMES: A M Murdoch, L P Thia, A Gupta, and C L Hogg Recurrent chest infection in a 5 year old boy BMJ 2009; 338: b945 [Full text]

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Recurrent chest infection in a 5 year old boy

Margaret R Jones   (11 May 2009)

Recurrent chest infection in a 5 year old boy 11 May 2009
Margaret R Jones, Retired Radiologist Cardiff and Vale NHS Trust(Teaching) Send response to journal: Re: Recurrent chest infection in a 5 year old boy	I wish to add a few comments on the interpretation of the chest Xray. Chest Xrays in the paediatric age group are the most difficult to interpret. The main pitfall is rotation of the patient which distorts anatomical detail. This rotated chest radiograph shows dextrocardia and situs inversus as described in the Short Answers on P 1111. However,the haziness in the right lung is caused by the overlying scapula. The right hilum, which should be at a higher level than the left, is not visible, suggesting loss of volume in the right lower lobe. There is a dense opacity in the right cardophrenic angle indicating consolidation in the lower lobe. The possibility of a sequestration segment should also be considered in a patient with a history of chronic chest infection from birth. Yours faithfully, Dr M R Jones MB BCh DMRD FRCR Competing interests: None declared