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Age: 12

Sex: Male

Indication: Chest pain, sickle cell disease

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Case #21


Findings

  • Hazy bilateral airspace opacification, worst in the lung bases, with dense retrocardiac opacification
  • Layering bilateral pleural effusions
  • Enlarged cardiopericardial silhouette


Diagnosis

  • Acute chest syndrome

Sample Report

Hazy bilateral airspace opacification, worst in the lung bases, with dense retrocardiac opacification. Findings are concerning for acute chest syndrome in this patient with sickle cell disease. Dense retrocardiac opacification may represent pneumonia.

Layering bilateral pleural effusions.

Enlarged cardiopericardial silhouette.


Discussion

  • The diagnosis of acute chest syndrome in sickle cell disease relies on the combination of a new clinical symptom and a new pulmonary opacity on chest radiograph
  • The etiology for acute chest syndrome varies and may be multifactorial including infection, lung ischemia, and atelectasis related to pain from bone infarcts
  • Pleural effusions are commonly present in this condition



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