This patient had pericarditis with a massive pericardial effusion. Pericardial effusions can be identified on chest x-rays by their smooth, symmetrically enlarged silhouette.
The Image of the Week for May 3 is brought to you in partnership with:
Submit your diagnosis to see full explanation.
The plump and saggy appearance of a full pericardium is sometimes called the water bottle sign.
To see more cases like this, visit Figure 1.