Presentation
Shortness of breath with background of end stage renal failure. To rule out fluid overload.
Patient Data
The catheter projected over the enlarged heart was confirmed by the referring clinician to be an external artifact.
Pulmonary venous congestion, bilateral perihilar haziness as well as small bilateral pleural effusions are suggestive of pulmonary edema. No free subdiaphragmatic gas observed.
Note: Linear density over neck region from patient's surgical mask.
Case Discussion
In this case, a central venous catheter was an external artifact that should have been removed prior to imaging. Doing so would prevent clinicians from mistaking:
the patient to have an anatomical variant
the catheter to be malpositioned
Radiographers performing imaging should always ensure that all removable artifacts have been moved out of the region of interest, and should also question the presence of any artifact. If such artifacts are not removed, proper documentation should then be performed to convey their presence on the radiograph.