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Pericardial Effusion – The Oreo Cookie Sign

History: 50 year old male with shortness of breath and chest pain. This is the classic “Oreo Cookie Sign” of pericardial effusion on the lateral chest radiograph. The most anterior radiolucent line (indicated by the red arrow) is the epicardial fat, the radiopaque line is the pericardial effusion, and the posterior radiolucent line (indicated by … Continue reading