Presentation and Findings: Asymptomatic 35 year old male presents with respiratory symptoms to rule out pneumonia. No focal airspace opacities seen to suggest pneumonia but there is a congenital variant of right sided aortic arch and knob visualized. No aneurysm or other vascular variant identified. No situs inversus is seen.
Key Points: Right-sided aortic arch is a variant characterized by the aortic arch with course to right of the airway. Various patterns can be seen with patterns of right-sided aortic arch associated with mirror image branching or right-sided aortic arch associated with with aberrant left subclavian artery (ALSA). On CXR, look for the absence of left-sided aortic contour. The trachea tends to bow towards the left slightly. Right sided descending aorta is also visualized adjacent or overlying the spine. Finding can be mistaken as a mass in the right paratracheal region.
Submitted by Dr. Mohammad Osama Yonso to radRounds Radiology Network