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Pleural effusion above the diaphragm, subphrenic ascites below the diaphragm superior to liver, hepatorenal space, and kidney. These structures must be positively identified before proper identification of a pleural effusion, subphrenic ascites, or both can be made. The image was obtained using a 3.5-MHz transducer. The transducer was in longitudinal orientation and placed perpendicular to the chest wall to scan through the eighth intercostal space in the right midaxillary line. Video available on AccessMedicine.com.