This chest x-ray is from a 27 year man who presented to the ED with a cough. What can you observe (it is simple), and what finding, normally associated with this condition, cannot be found in the x-ray?

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The chest x-ray, with the marker applied appropriately, shows dextrocardia and a right sided aortic arch. There is situs inversus with the liver on the left and bowel gas shadows on the right side. The lung fields are clear; the left dome of the diaphragm is higher than the right.

There is no x-ray evidence of bronchiectasis, which is found in association with Kartagener syndrome or immotile cilia syndrome (chronic sinusitis, bronchiectasis, situs inversus).

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