Subpulmonic pleural effusion
Increasing shortness of breath. Cough for 3 days. Past history of left heart failure.
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Apparent elevation of the right hemidiaphragm but with a lateralized dome (arrow) on the anterior view and minor but definite fluid tracking up the oblique fissure on the lateral projection (arrow).
Subpulmonic effusions sit between the lung and hemidiaphragm, and can be difficult to differentiate from elevated hemidiaphragm on the chest X-ray.