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Silhouette sign of Felson - right middle lobe pneumonia

Case contributed by Garth Kruger
Diagnosis almost certain

Presentation

A young woman is sent with a diagnosis of pneumonia.

Patient Data

Age: 25 years
Gender: Female

Consolidation of the anterior segment of the RUL and the middle lobe of the right lung. Moderate volume loss of the middle lobe.

Case Discussion

Demonstration of Felson's silhouette sign. On the PA view, the anterior segment consolidation is seen superior to the minor fissure of the right lung.

The silhouette sign is noteworthy because it is described when something "disappears" rather than when it "appears", as is usual in the rest of medicine.

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