Sickle cell anemia
Symptoms of chest infection.
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The lateral CXR shows multiple vertebral end-plate irregularities and depressions. The peripheral portions of the end-plates are spared. The appearance is due to bone infarction and subsequent collapse.
The patient had a history of sickle-cell anemia.
This is an early example of the classical H-shaped vertebrae seen in sickle-cell anemia. H-shaped vertebrae are a characteristic finding seen in ~10% of patients with the disease. Bone infarction may be complicated by Salmonella osteomyelitis. Other signs to look for on chest films are cardiomegaly, absent spleen, and cholecystectomy clips.