Science and Education Publishing American Journal of Medical Case Reports 2 9 2014 09 02 ‘Tennis Racket cavity’on Chest Radiograph: Strong Predictor of Active Pulmonary Tuberculosis!- A Case Report 167 169 EN Patil Shital Department of Pulmonary Medicine, MIMSR Medical College, Latur India Laxman Kasture AJMCR2014291 10.12691/ajmcr-2-9-1 2014 08 22 2014 08 29 2014 09 02 Tuberculosis is the leading cause of cavitation on chest radiograph, more than 90% cases with cavitary lung diseases are because of tuberculosis especially in high burden countries like India. Overall 8-24% of pulmonary tuberculosis cases are having cavitation on chest radiograph. Although no radiological feature is the predictor of tuberculosis, some morphological characteristic features of lung cavitation on chest radiograph will help in predicting active form of pulmonary TB from cured form of disease. In this case report we described a 26 year male, with symptoms of weight loss, fever and cough of 2 months duration, found to have‘Tennis Racket cavity’ on chest radiograph. We investigated further and found to have sputum smear positive pulmonary TB. We documented therapeutic response to the routine anti tuberculosis (ATT) drugs, and shown complete clinical and radiological recovery. Careful chest radiograph evaluation and interpretation is must in all the cases with respiratory symptoms, high index of suspicion with adequate chest radiology training is key in high burden setting especially in South East Asian region to cut the transmission of disease.