Table of Contents

HK J Paediatr (New Series)
Vol 6. No. 2, 2001

HK J Paediatr (New Series) 2001;6;149

Clinical Quiz Answer

What is the Diagnosis?

CY Yeung

Case 1:

(a) Pale-looking with sallow-complexion; mild frontal bossing, depressed nasal bridge and prominent cheek bone (maxillae).

(b) Thalassaemia major.

(c) Because most children with this condition are treated early with high-transfusion regime. They do not sustain prolonged period of anaemia and therefore they do not develop significant bone-marrow hyperplasia.

Case 2:

(a) Barrel-shape chest, horizontally positioned ribs, hyper-inflated lungs, elongated mediastinal structures, flat and low diaphragm, vascular and bronchial streaks. Note: counting of the anterior ribs would not help with the diagnosis, as it depends on the direction of the X-ray beam.

(b) Acute-on-chronic asthma

(c) No, because a first attack of air-trapping would not be able to stretch the lungs so much to produce such a barrel-configuration with the upper part even wider than the lower chest (which is restricted by the liver).


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