Pediatric Acute Chest Syndrome

Etiology: Pulmonary thrombotic crisis resulting in micro-infarcts precipitated by infection in sickle cell disease
Imaging CXR:
— Infiltrates related to acute chest syndrome
— H-shaped vertebral bodies
— Avascular necrosis of humeral heads
— Small splenic shadow
— Gallstones or cholecystectomy clips
DDX:
Complications:
Treatment:
Clinical:

Radiology Cases of Acute Chest Syndrome

CXR of acute chest syndrome in sickle cell disease — CXR AP shows bibasilar infiltrates, right greater than left, and a small right pleural effusion.

CXR of acute chest syndrome — CXR AP (left) shows a dense opacity in the left lower lobe which on the lateral (right) is seen to be located posteriorly, causing a spine sign. The lateral radiograph also shows the T8 and T10 vertebral bodes to be H-shaped.

CXR of H-shaped vertebral bodies in sickle cell disease — CXR AP (left) shows opacity in the left lower lobe that on the lateral (middle) is located posteriorly (spine sign). The vertebral bodies (right) have an H-shaped appearance throughout the thoracic and lumbar spine.

Radiology Cases of Bacterial Pneumonia in Patients With Sickle Cell Disease

CXR of bacterial pneumonia in right upper lobe — CXR PA (left) shows an opacity in the right upper lobe which on the CXR lateral (right) is seen to be located posteriorly causing a spine sign.