Chest X-Ray Challenge!

Take a look at the following seven chest X-Rays. The accompanied history is super vague on purpose I swear. Post your answers in the comments. Enjoy!

Toddler with tachypnea and upper respiratory infection

Toddler with tachypnea and upper respiratory infection

School age child with fever and cough

School age child with fever and cough

Child with sickle cell anemia and chest pain

Child with sickle cell anemia and chest pain

Teen that developed chest pain abruptly while playing basketball

Teen that developed chest pain abruptly while playing basketball

Driver of a rollover motor vehicle accident

Driver of a rollover motor vehicle accident

Infant with congestion, cough and tachypnea

Infant with congestion, cough and tachypnea

Infant with congestion, cough and tachypnea

Infant with congestion, cough and tachypnea

By | 2016-12-14T12:57:05+00:00 February 22nd, 2013|Radiology|

About the Author:

Brad Sobolewski, MD, MEd is an Assistant Professor of Pediatric Emergency Medicine and an Assistant Director for the Pediatric Residency Training Program at Cincinnati Children’s Hospital Medical Center. He is on Twitter @PEMTweets and authors the Pediatric Emergency Medicine site PEMBlog. All views are strictly my own and not official medical advice.

10 Comments

  1. dave February 26, 2013 at 8:46 PM

    Since no one else will make any guesses:
    1) Boot shaped heart? Tetrology of Falot?
    2) Mediastinal Mass? Lymphnode/lymphoma?
    3) Dunno, cardiomegally?
    4) Pneumo
    5) Pneumo and ET tube
    6) RML pna?
    7) Bilateral infiltrates, some peribronchial cuffing. viral pneumonitis? RSV?

    Meh, they probably all have rsv, (except 4&5, they definitely have a pneumo…and rsv). Why are you getting so many x-rays on kids with rsv?

    • Brad Sobolewski February 26, 2013 at 8:50 PM

      #1 is close, it isn’t Tetralogy, but the odd shape is due to a Right sided aortic arch
      #2 is a classic example of a round pneumonia most often caused by strep pneumo
      #3 is Cardiomegaly – BINGO!
      #4 is a Pneumothorax
      #5 is a Tension Pneumothorax
      #6 and #7 are both the dreaded “viral versus reactive airways disease”

  2. Matt February 27, 2013 at 11:16 AM

    Great series

    • Brad Sobolewski February 27, 2013 at 11:33 AM

      Thanks! I’ll look to include some more like this is the future

  3. Jack March 14, 2013 at 11:37 AM

    awesome xrays to review brad!

    Jack

  4. Dave Ege January 14, 2014 at 1:00 AM

    Could the person in #4 also have Marfan’s? If so, we may need to consider other cardiac etiologies of sudden onset chest pain.
    Great pictures. Thanks for posting.

    • Brad Sobolewski, MD, MEd January 14, 2014 at 9:05 AM

      Interesting thought Dave – in my institution we “allow one” spontaneous pneumo and don’t necessarily do genetic studies unless there is a family or personally concerning history

  5. The LITFL Review 096 - LITFL November 24, 2014 at 9:19 AM

    […] Chest X-Ray Challenge! – Are you up for it, and the history doesn’t give you much! […]

  6. R Brock May 22, 2015 at 2:00 AM

    Enjoyed the images. Learned through comments. Thanks all!
    PA student- UW

Comments are closed.