CTICasesPectus Pseudo-pneumonia
Imaging findings
Chest radiograph shows an apparent opacity in the right lower lung zone obscuring the right atrium and lower heart border, mimicking right middle or lower lobe pneumonia. CT of the chest demonstrates severe pectus excavatum compressing and shifting the heart to the left, which creates a pseudo-opacity due to the compressed anterior chest wall tissues and loss of a sharp mediastinal tangent.
Key takeaways
Severe pectus excavatum can cause a classic pseudo-pneumonia appearance on frontal chest radiographs, characterized by increased density in the right cardiophrenic angle and obscuration of the right heart border. Recognizing this skeletal deformity on frontal or lateral views prevents unnecessary antibiotic treatment and imaging.
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