This diagnostic image is a front-on chest radiograph (X-ray), labeled as a portable study, demonstrating the placement of a right internal jugular dialysis catheter. The radiopaque catheter is seen entering via the right neck, coursing inferiorly through the superior vena cava. The distal tip is correctly positioned, projecting at the right cavoatrial junction. The anatomical structures, including the cardiac silhouette, mediastinum, and hila, appear within normal limits. The lung fields are clear bilaterally with no evidence of focal consolidation, pleural effusion, or pneumothorax. Bony structures, including the ribs, clavicles, and scapulae, are unremarkable. This radiograph serves as a clinical evaluation for catheter tip placement and to rule out acute cardiopulmonary complications, such as infectious processes or procedural trauma, in a patient with end-stage renal disease (ESRD).

This diagnostic image is an anteroposterior (AP) portable semi-erect chest radiograph demonstrating a malpositioned dialysis catheter. The primary finding is a radiopaque double-lumen dialysis catheter entering via the left internal jugular vein. Rather than following the expected course into the superior vena cava, the catheter tip is positioned anomalously within the mediastinum, directed toward the left hilum. The image displays the cardiothoracic silhouette, ribs, and clavicles, with an endotracheal tube and additional monitoring lines also visible. The lung fields are largely clear, though limited by image quality, with sharp costophrenic angles. This visual serves as a critical educational example of central venous access complications, illustrating the importance of post-procedural radiographic verification to identify improper placement and potential vascular anomalies, such as an anomalous left superior pulmonary vein or persistent left superior vena cava.

Anteroposterior (AP) chest X-ray radiograph demonstrating the placement of a Totally Implantable Venous Access Device (TIVAD) via the right internal jugular vein (IJV). The radiopaque catheter is visible entering the soft tissues of the right neck, crossing over the medial third of the right clavicle, and descending toward the superior vena cava. A prominent white arrow indicates a sharp acute angle or folding point where the catheter traverses the clavicle, reflecting potential mechanical stress or kinking due to a high puncture site. Anatomical structures including the right clavicle, ribs, and mediastinal shadow are visualized. This image serves as a clinical example of procedural outcomes and potential catheter complications, such as bending or restricted flow, associated with the IJV approach for venous port implantation.