School ager with asymmetric pulses in the upper and lower extremities

CT of post-ductal coarctation of the aorta
Sagittal CT (above left) and 3D CT (above right) with contrast of the chest show significant narrowing of the proximal descending aorta distal to the origin of the left subclavian artery. Anterior 3D CT (below left) shows dilated bilateral collateral internal mammary arteries and posterior 3D CT (below right) shows dilated bilateral collateral 3rd-8th intercostal arteries.

The diagnosis was post-ductal coarctation of the aorta.