PROBLEM
This 50-year-old man is being evaluated for possible pneumonia. What is your interpretation of the frontal and lateral views of his chest?

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ANSWER
The findings are normal. In the frontal view, the large densities at the cardiac apex (right arrow) and right cardiophrenic angle (left arrow) represent huge epipericardial fat pads.
The lateral view supports that interpretation by demonstrating consistent retrosternal positioning of these large densities in a typical, homogeneous configuration.

This series of diagnostic quizzes that challenge your ability to read a variety of x-ray films is edited by Dr. Keats, alumni professor of radiology at the University of Virginia School of Medicine in Charlottesville. Emerg Med 38(8):57-8, 2006