Continuous diaphragm sign
Background of Apert syndrome, tracheostomy in place, admitted with severe pneumonia. A follow up chest radiograph was requested as the patient deteriorated.
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There is a linear lucency at the base of the heart, giving an impression of a continuous diaphragm, representing the continuous diaphragm sign and lucency along the right superior mediastinum consistent with pneumomediastinum. All this is on a background of extensive bilateral confluent opacification.
Right sided ventriculoperitoneal shunt traverses the chest. Tracheostomy in place.
Our patient stayed in ICU for several months, later improved and was discharged home.