Coarctation of the aorta

Case contributed by Frank Gaillard

Patient Data

Age: 12 years
Gender: Male
  • Note: This case has been tagged as "legacy" as it no longer meets image preparation and/or other case publication guidelines.

Chest x-ray demonstrates slight indentation of the aorta (figure of 3 sign) with associated inferior rib notching (Roesler sign).

Annotated image

Arrows identify prominent inferior rib notching due to enlargement of intercostal arteries. 


CTA demonstrating coarctation of the aorta just distal to the left subclavian artery. Marked enlargement of the intercostal and internal mammary arteries is present resulting in rib notching. 

Case Discussion

Aortic coarctation can be difficult to identify on chest x-ray and routine review of aortic outline, as well the inferior rib notching, which is known as Roesler sign when coarctation is the cause, which is necessary if one is to make the diagnosis. 

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