Artifactual hemithorax white-out and aortic knuckle calcification

Case contributed by Anne Marie Bonnici Mallia

Presentation

80 year old gentleman presented with a GI bleed to the acute medical team. PMH Diabetes, Stroke with residual left sided weakness, HTN. On examination chest was clear. CXR taken to check for air under the diaphragm in case of GI perforation

Patient Data

Age: 80
Gender: Male

Noted what initially appeared to be whiteout of the left side of the lung. Additionally there appeared to be calcification of the aortic knuckle.

Patient denied any breathing problems, SOB, purulent sputum or haematemesis. Chest was re-examined and was clear.

Noted on further inspection that whiteout of lung was caused by over positioning of left hand and forearm over the chest. He could not move these himself due to residual weakness from his previous stroke. "Calcification of aortic knuckle" was noted to be the patient's ring. 

Repeat chest x-ray demonstrates no acute changes. 

Case Discussion

Being aware of artifacts on chest x-ray is important as not misdiagnose and misdirect patient care. 

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Case Information

rID: 40276
Case created: 15th Oct 2015
Last edited: 4th Mar 2016
Inclusion in quiz mode: Included

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