Presentation
Three days of fever, cough and tachycardia.
Patient Data
Density in the shape of a coil seen projecting over the superior mediastinum/lower neck on the AP view, and overlying the upper back on the lateral view consistent with a hair tie.
Case Discussion
A chest x-ray was requested to rule out pneumonic process versus foreign body aspiration.
Hair elastics/ties/bands can pose a clinical challenge when discerning whether or not they have been ingested. The key on this x-ray is that the hair tie extends out from the borders of the mediastinum on the frontal radiograph, with its position confirmed on the lateral exam. To truly rule out a radiolucent foreign body, both lateral decubitus views would be useful in identifying air trapping within the affected lung.
Differential diagnosis includes:
- artifact
- foreign body ingestion vs aspiration
This case was submitted with supervision and input from:
Soni C Chawla, M.D.
Associate Professor
Department of Radiological Sciences
David Geffen School of Medicine at UCLA
Olive View - UCLA Medical Center