Right paratracheal stripe
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The right paratracheal stripe is a normal finding on the frontal chest x-ray and represents the right tracheal wall, adjacent pleural surfaces and any mediastinal fat between them. It is visible because of the silhouette sign created by air within the trachea medially and air within the lung laterally.
It normally measures less than 4 mm 1,2 and thickening is non-specific but may represent 3:
- paratracheal lymphadenopathy
- thyroid malignancy
- parathyroid malignancy
- tracheal malignancy
- pleural effusion
- post esophagectomy with stomach pull through or colonic interposition (look for the feeding tube)
Recognition of any abnormality in the right paratracheal stripe is invaluable in ensuring the appropriateness in further investigation with CT 1.
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