Left lower lobe pneumonia
Shortness of breath, fever and rigors
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Opacity projected behind the heart on the PA radiograph with loss of visualisation of the left hemidiaphragm consistent with collapse / consolidation throughout the left lower lobe. Small focus of linear atelectasis in the left costophrenic recess region. Right lung and pleural space are clear. Normal cardiomediastinal contour. Cholecystectomy clips noted.
Typical chest radiograph appearance of left lower lobe pneumonia with collapse / consolidation. Loss of left hemidiaphragm visualisation (silhouette sign) and inability to trace the normal lung vessels behind the heart are the keys to identifying this on the PA radiograph.