There is a Port-a-cath venous line with the tip projected over the expected position of the SVC. The lungs are clear and the mediastinum has normal contours. The vertebral bodies are abnormal in shape with depression of the end plates, leading to H-shaped vertebral bodies. There are surgical clips in the right upper quadrant of the abdomen, indicating a previous cholecystectomy. Bowel gas is present in the left upper quadrant, with no spleen detectable. All of these features lead to the diagnosis of sickle cell disease.