CTICasesPectus Excavatum Mimicking Pneumonia
Imaging findings
A frontal chest radiograph demonstrates a vague, ill-defined increased opacity adjacent to the right heart border. Subsequent chest CT reveals severe, asymmetric pectus excavatum with a Haller index of 6.5, compressing and shifting the heart to the left.
Key takeaways
Severe pectus excavatum can cause a "pseudo-pneumonia" appearance on frontal radiographs. This artifact is created by the focal loss of the right heart border outline, increased tissue density from the overlapping shifted chest wall tissues, and compression of the right middle lobe.
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