Frontal and lateral chest radiographs demonstrates multiple bone and soft tissue findings associated with sickle cell disease:

• H-shaped vertebrae with central end plate depression involving the superior and inferior endplates
• Bilateral patchy humeral head sclerosis consistent with epiphyseal infarction
• Absent splenic shadow with loops of bowel replacing the left upper quadrant abdomen suggesting autosplenectomy.  Later confirmed on CT (not shown)
• Calcified gallstones seen in the right upper quadrant abdomen from radio-opaque bilirubin/pigmented gallstones
• Enlarged heart secondary to chronic anemia
• Enlarged liver shadow (not completely imaged) in keeping with hepatomegaly