Assessment of bones and soft tissue on chest x-ray
Described below are points to consider on assessment of bones and soft tissue on chest x-ray.
-
ribs
- rib fractures
- lesions (most commonly metastases): may appear as lucent and/or sclerotic; inverting contrast may help in identification
- previous surgery, e.g. thoracotomy with rib resection
-
vertebrae
- fractures: compression are common traumatic fracture can be difficult to identify
- lesions: commonly incidental benign (e.g. hemangioma) and less commonly skeletal metastases
- pectoral girdle: fractures, distal clavicular erosion, sclerosis
-
soft tissue
- asymmetric soft tissue may indicate a mastectomy (common), soft tissue mass or Poland syndrome
- surgical clips, e.g. lobectomy, pneumonectomy, mastectomy, axillary clearance, thyroidectomy
- subcutaneous emphysema and soft tissue injuries