Premature newborn after PICC placement

CXR of peripherally inserted central catheter / PICC changing in position as arms move up and down
CXR AP with the left arm down (left) shows the tip of the left upper extremity PICC to project deep within the right atrium. CXR AP with the left arm up (right) obtained later the same day shows the tip of the PICC to have moved back into the superior vena cava. There is ground glass opacity throughout the lungs.

The diagnosis was change in position of the upper extremity PICC tip due to change in arm position in a patient with respiratory distress syndrome.