Button mimicking a coin lesion

Case contributed by Dr Craig Hacking

Presentation

Pre CABG and AVR workup.

Patient Data

Age: 75 - 80 years
Gender: Female
X-ray

Initial chest X-ray:

A 10 mm ovoid nodule at opacity is projected over the lower half of the medial end of the left clavicle which is not resolved on the lateral projection. This may be associated with the sternoclavicular or degenerative first costochondral joint, it may represent pulmonary or pleural nodule or it may be outside the patient.

Mild peribronchial thickening bilaterally. The pleural spaces are clear. Heart size and mediastinal contours are normal. No pneumothorax or free subdiaphragmatic gas.

Repeat chest X-ray:

A repeat frontal chest x-ray with the patient's gown removed shows absence of the left apical nodule and hence a clothing-related artefact.

Case Discussion

Beware of clothing mimicking pathology!

It's always wise to ask the radiographer if the patient had clothing in the field of view.

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Case information

rID: 37852
Case created: 24th Jun 2015
Last edited: 12th Aug 2017
System: Chest
Inclusion in quiz mode: Included

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