Medical devices in the thorax

Last revised by Amanda Er on 19 Jun 2022

Medical devices in the thorax are regularly observed by radiologists when reviewing radiographs and CT scans.

These devices are a common cause of artifacts and may trip the unweary, but in general are recognized for what they are.

The following are more important to be recognized by the radiologist:

  • thoracostomy tubes
    • usually placed anterosuperiorly to drain pneumothorax, and posteroinferiorly to drain pleural effusion
    • a well-positioned tube should lie between visceral and parietal pleura, and there should not be any kinking
    • to check the correct positioning, frequently AP and lateral views are required. Supplemental CT scan may also be performed.
    • should not enter the interlobar fissure, else it may be blocked 1; tip should not be within the lung parenchyma or subcutaneous tissue
    • all drain holes should be in the pleural cavity to ensure effective drainage 5
  • pigtail catheter: used in empyema drainage
  • Heimlich valve: it is a one-way valve used for pleural space drainages, which prevents the return of gases or fluids into the pleural space
  • plombage: "ping-pong ball" plombage and wax plombage (historically used for tuberculosis, but no longer)

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Cases and figures

  • Case 1: breast implants on lateral radiograph
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  • Case 2: esophageal stent
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  • Case 3: hypoglossal nerve stimulator
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  • Case 4: Mitraclip
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  • Case 5: aortic and mitral prosthetic valves
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  • Case 6: pacemaker
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  • Case 7: biventricular cardiac pacemaker
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  • Case 8: ASD closure device
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  • Case 9: embolization coils
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  • Case 10: implantable cardiac defibrillator (ICD)
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  • Case 11: congenital pulmonary valve stenosis
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  • Case 12: cardiac event recorder
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  • Case 13: intra-aortic balloon pump
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  • Case 14: left ventricular assist device (LVAD)
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  • Case 15: left ventricular assist device (LVAD)
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  • Case 16: Amplatz occluder device
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  • Case 17: intra-aortic balloon pump
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  • Case 18: Amplatz occluder
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  • Case 19: epicardial pacing wires
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  •  Case 20: embolization coils
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  • Case 21: deep brain pulse stimulator
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  • Case 22: scoliosis clips
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  • Case 23: pericardiocentesis catheter
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  • Case 24: ASD closure device
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  • Case 25: displaced pacemaker lead
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  • Case 26: epicardial patch
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  • Case 27: breast implants
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  • Case 28: chest port
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  • Case 29: rib ORIF
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  • Case 30: wireless pH probe
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  • Case 31: cooling blanket
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  • Case 32: Passy-Muir valve
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  • Case 33: 24 hour ambulatory impedance pH test
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  • Case 34: plombage
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  • Case 35: antibiotic spacer
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  • Case 36: left atrial appendage occlusion device
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  • Case 37: pre-sternal peritoneal dialysis catheter
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  • Case 38: Impella LVAD
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  • Case 39: pulmonary stents
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  • Case 40: lung volume reduction coils
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  • Case 41: phrenic nerve stimulators
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  • Case 42: breast tissue expander implants
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  • Case 43: left atrial appendage clip
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  • Case 44: Dobhoff tube
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  • Case 45: Sengstaken-Blakemore tube
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  • Case 46: infusaport with infusothorax
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  • Case 47: Heimlich valve
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  • Case 48: wearable external defibrillator
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  • Case 49: Parachute device
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  • Case 50: endobronchial valves for emphysema
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  • Case 51: bronchial endovalve
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  • Case 52: VV ECMO
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  • Casse 53: double lumen cannula for VV ECMO
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  • Case 54: esophageal manometer
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  • Case 55: Watchman device
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  • Case 56: pH probe
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  • Case 57: PDA closure device
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  • Case 58: Minnesota tube
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  • Case 59: Fish Glassman viscera retainer
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  • Case 60: pectus excavatum treated with Nuss bar
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  • Case 61: PDA closure device
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  • Case 62: CardioMEMS device
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  • Case 63: Zio Patch
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  • Case 64: expandable breast implant
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  • Case 65: esophageal temperature probe
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  • Case 66: armoured endotracheal tube
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  • Case 67: Titanium chest bars and rib clips
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