Situs inversus on flipped and incorrectly labelled chest x-ray

Case contributed by Dr Henry Knipe

Presentation

URTI and chest pain.

Patient Data

Age: 30
Gender: Female

The x-ray has been mislabelled ("R" label indicates patient's left hand side) and the study has been loaded onto PACS as mirror image. Situs inversus demonstrated with gastric bubble, apex of the heart and aortic arch on the right. Retrocardiac consolidation consistent with infection. Cardiomediastinal contour is otherwise within normal limits.

If there is prior imaging - remember to always review it. The next chest x-ray is from nine months earlier. 

Dextrocardia and situs inversus is demonstrated, with the stomach bubble/fundus on the right. Right-sided aortic arch. The cardiomediastinal contour is otherwise within normal limits. Lungs and pleural spaces clear.

Case Discussion

This is a good example of the need to always review the prior imaging and if something is not quite right (e.g. misplaced ECG leads), don't dismiss it...

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Case information

rID: 27018
Case created: 18th Jan 2014
Last edited: 30th Aug 2016
System: Chest
Inclusion in quiz mode: Included

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