CASE 5
ANSWER: Congenital rubella.
                  She had patent ductus arteriosus and bone changes.
.
The chest film shows mild cardiomegaly and slightly enlarged pulmonary arteries. The cardiac apex points
downward and laterally, suggesting left ventricular enlargement. Note inhomogeneous density of the proximal
metaphyses of both humeri.
..
The film of the lower extremities shows longitudinal striation of sclerotic and radiolucent areas
(celery stalk appearance) at the metaphyses. The changes are most pronounced around the knees.
The epiphyseal centers are not seen. Note dense metaphyseal bands, irregularity of the metaphyses,
and narrowing of the medullary cavities.
..

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