This is the answer page to Case 12 from the page titled What is the Value of the Lateral Chest Projection?

• What is the Value of the Lateral Chest Projection?

• Patterns of Consolidation

• Lung Anatomy

This 24 year old female was referred for chest radiography with a possible axillary DVT. The chest radiography was preformed to assess possible cervical ribs. Imaging was performed with a DR system There is loss of visualisation of the right heart border There is a mild scoliosis concave to the left 11 posterior ribs are seen above the diaphragm indicating overexpansion of the lungs Note the upward curvature of the posterior ribs that can be associated with pectus excavatum

There is pectus excavatum (arrowed) which is associated with loss of visualisation of the right heart border Pectus excavatum refers to the depressed inferior sternum. This condition can leave insufficient space for the heart between the sternum and thoracic vertebral bodies causing the heart to displace to the left. It is this displacement to the left that results in the failure of visualisation of the right heart border