Presentation
Fever and cough
Patient Data
Age: 25 years
Gender: Male
From the case:
Retrocardiac pneumonia
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The left hemidiaphragm is not visualised in keeping with retrocardiac (left lower lobe) consolidation. The left heart border is visualised normally. The right lung appears clear.
From the case:
Retrocardiac pneumonia
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Dense consolidation of the left lower lobe, with an effusion at the left apex.
The sagittal view shows how the consolidation abuts the posterior aspect of the heart and diaphragm, causing the silhouette sign.
Case Discussion
This radiograph nicely illustrates the silhouette sign. The left hemidiaphragm is not visualised, whereas the left heart border is normal - this localises the pathology to the left lower lobe.
At first glance, retrocardiac consolidation can be difficult to visualise and therefore it is an important review area.