Infant with respiratory distress

AXR of chylous ascites in child abuse
CXR AP (left) shows the lungs to be poorly expanded and clear but there are dense areas of callus along the lateral aspect of the right 3rd-5th ribs. Centralization of the loops of bowel were also incidentally noted and confirmed on a subsequent AXR AP (right).

The diagnosis was chronic right 3rd-5th lateral rib fractures and low lung volumes due to ascites which was found to be chylous when tapped in a child abuse patient.