Effect of morbid obesity (portable chest x-ray)
BMI over 40, septic, right jugular CVC placement.
Supine AP CXR (mobile unit)
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Contrast and image quality (note diffuse haziness) is greatly reduced by the extreme thickness of subcutaneous fatty tissue. The CVC appears in a normal position, no gross abnormalities can be seen.
Morbid obesity is a true diagnostic challenge, limiting if not ruling out entirely the access to axial imaging modalities, and significantly reducing the usefulness of ultrasound and x-ray. Not being able to perform state of the art imaging exams on these patients further worsens their mortality.