[Christmas article. When the hearth leads the way]

Area of Science:

• Medical imaging
• Anatomical variations
• Radiology

Background:

• Situs inversus is a rare congenital condition characterized by the transposition of thoracic and abdominal organs.
• This anatomical variation can complicate medical diagnosis, particularly in emergency situations involving acute abdominal pain.
• Accurate identification of organ positioning is crucial for effective patient management.

Observation:

• A patient with situs inversus was initially identified via CT scan for urolithiasis.
• The condition was retrospectively observed on a prior chest X-ray.
• Interestingly, both the patient's cardiac apex and a jewelry heart pendant were visualized on the right side of the chest.

Findings:

• The case report details the incidental finding of situs inversus during imaging for an unrelated condition.
• The simultaneous visualization of the patient's heart apex and a jewelry heart on the right side is a unique observation.
• This specific radiographic finding is proposed as a potential new diagnostic sign, termed 'goldsmith's sign'.

Implications:

• The 'goldsmith's sign' could serve as a novel, easily recognizable indicator of situs inversus on chest X-rays.
• Widespread recognition of this sign may improve the early detection of situs inversus.
• Early detection can prevent diagnostic delays and potential mismanagements in patients with this condition.