This is a teenage girl who presented with shortness of breath, right-sided shoulder pain and back pain. On ultrasound, she was found to have a large complex effusion with septations concerning for empyema. The phased-array transducer was used in order to have the depth to capture the fluid collection in the right chest. On CT scan, she was found to have necrotizing pneumonia with multiloculated empyema and ultimately required a VATS.

“The information in these cases has been changed to protect patient identity and confidentiality. The images are only provided for educational purposes and members agree not to download them, share them, or otherwise use them for any other purpose.”