Osteophyte-induced adjacent pulmonary atelectasis and fibrosis

Last revised by Yuranga Weerakkody on 4 Dec 2022

Osteophyte-induced adjacent pulmonary atelectasis and fibrosis are typically seen as focal pulmonary interstitial opacities adjacent to thoracic spinal osteophytes. They are a relatively common finding in thoracic CT imaging.

They are more common in older individuals.

They are thought to represent a variable combination of compressive atelectasis ± fibrosis (focal pulmonary fibrosis).

They are typically seen involving the medial basal segment of the right lower lobe and posterior segment of the left lower lobe where osteophytes are more commonly located. 

Some studies have suggested that the likelihood of lung fibrosis is commensurate with the size of the osteophyte 3. Subpleural fat is considered a protective measure against osteophyte-induced lung fibrosis.

Most are not thought to be of clinical significance, generally do not appear to progress, and are not considered a pre-clinical form of more extensive fibrosing lung disease 2.

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