An 18-year-old woman presented to the infectious diseases clinic with a recurrent lower urinary tract infection, but on a routine full-body examination, she was noted to have a right hypoplastic pectoralis major muscle and breast (figure 1, panel A), plus brachydactyly of the right hand (figure 1, panel B). The patient reported that these findings had been present since birth. She noted no diminished strength or decreased range of motion, and the hypoplastic pectoralis major muscle only represents an aesthetic concern. A clinical diagnosis of the Poland syndrome (PS) was made, and she was sent to thoracic surgery to consider a reconstructive procedure. With this new diagnosis and a history of recurrent lower urinary tract infections, a kidney ultrasound was performed, finding a right double ureter, and subsequently she was started on nitrofurantoin prophylaxis until further evaluation by urology. PS is a rare congenital condition classically characterised by unilateral absence or underdevelopment of chest-wall muscles, and a wide spectrum of associated ipsilateral thoracic and upper extremity anomalies. These include hypoplasia or aplasia of the breast or nipple, deficiency of subcutaneous fat and axillary hair and hand deformities ranging from syndactyly to ectrodactyly.1