Known sickle cell disease, presenting with chest pain.
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Cardiac silhouette is mildly enlarged. There is bilateral lower zone atelectasis and hazy airspace opacities. Bones are diffusely sclerotic with multi-level H-shaped vertebral bodies. Splenic shadow is difficult to visualise.
Case DiscussionSickle cell disease is a haemoglobinopathy resulting from a mutation in the beta globin gene. Resultant haemoglobin S, particularly in low oxygen tension states, results in abnormal red blood cell sickling with microvascular occlusion and tissue ischaemia/infarction. Given the clinical history in this case, regions of lower zone atelectasis and airspace opacity are supportive of acute chest syndrome.