The tip of the tracheostomy tube terminates at T3 level, appears to be well above the carina which is not well evident on this exam.
Low lung volumes and poor inspiratory effort largely exaggerate the cardiomediastinal silhouette and the central pulmonary vascularity and limits evaluation for cardiomegaly and volume overload.
Streaky, bandlike and airspace opacities in the right perihilar region with some air bronchogram may be due to atelectasis and/or pneumonia versus aspiration. No definite pleural effusion or pneumothorax.
Posterior spinal fusion Harrington rods are seen in place without evidence of hardware failure or loosening.
The visualized humeral shaft is thin and gracile with diffuse muscular atrophy. Both clavicles and the ribs are also thin with diffuse atrophy of the soft tissues in patient, most compatible with Duchenne muscular dystrophy.
Nonspecific bowel gas pattern is noted in the visualized upper abdomen.