Chest X-ray ward round

What does the X-ray show?

• Dextrocardia and stomach gas bubble on right

What is the diagnosis and differentials?

• Situs inversus
• Primary Ciliary Dyskinesia (Kartagener's syndrome)

What is the management?

• Situs inversus requires no management
Primary Ciliary Dyskinesia:
• Diagnosis: Nasal NO test (low level is positive), nasal brush biopsy, and genetic testing
• Treatment: Chest physiotherapy, bronchodilators, mucolytics and aggressive antibiotic therapy when required
• Patients also prone to get otitis media, chronic sinusitis and infertility