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A circular challenge
  1. Helen Williams
  1. Correspondence to Dr Helen Williams, Radiology Department, Birmingham Children's Hospital, Birmingham B4 6NH, UK; helen.williams{at}

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This 13-year-old girl presented with several days’ history of anorexia, cough and pleuritic chest pain. She had no significant medical history. On examination, she was dehydrated, tachycardic and had a temperature of 39.5°C, but there were no chest signs on examination. A chest radiograph was performed as chest infection was suspected and she was admitted for treatment. Look at the posteroanterior (PA) and lateral chest radiographs and consider the following questions (figures 1 and 2).

Figure 1

Posteroanterior chest radiograph.

Figure 2

Lateral chest radiograph.


  1. The abnormality is in the left upper lobe. (True or false?)

  2. The abnormality is in the left lower lobe. (True or false?)

  3. The abnormality is in the mediastinum. (True or false?)

  4. The patient requires a CT scan for further evaluation. (True …

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  • Competing interests None declared.

  • Provenance and peer review Commissioned; internally peer reviewed.