Case submitted by Mohammad Osama Yonso, M.D., radiologist, to

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 Asymptomatic 35-year-old male presents with respiratory symptoms to rule out pneumonia. No focal airspace opacities are seen to suggest pneumonia, but there is a congenital variant of right-sided aortic arch and knob visualized. No aneurysm or other vascular variant are identified. No situs inversus is seen.

 Right-sided aortic arch is a variant characterized by the aortic arch with course to right of the airway. Various patterns can be seen with patterns of right-sided aortic arch associated with mirror image branching or right-sided aortic arch associated with with aberrant left subclavian artery (ALSA). 

On chest X-ray, look for the absence of left-sided aortic contour. The trachea tends to bow towards the left slightly. Right-sided descending aorta is also visualized adjacent or overlying the spine. Finding can be mistaken as a mass in the right paratracheal region.

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What is your diagnosis on this patient who got a CXR to rule out pneumonia?






Image IQ Quiz: Asymptomatic Patient Presents with Respiratory Symptoms