Sclerotic rib lesion simulating a pulmonary nodule

Case contributed by Dr Andrew Dixon

Presentation

Recent TAVI (transcatheter aortic valve implantation)

Patient Data

Age: 85 years
Gender: Male
X-ray

Chest x-ray

Nodule projected in the left mid zone. Note how the nodule "moves" relative to the lung but remains directly associated with the anterior aspect of the left fourth rib on both the PA and AP projections. This indicates that the lesion is associated with the rib which is confirmed when looking back at the prior TAVI planning CT. 

Sclerotic lesion confirmed within the anterior aspect of the left 4th rib on CT. This was thought to represent a benign bone island (enostosis). 

Case Discussion

Sclerotic rib lesions can mimic pulmonary nodules. The key is to look back at any prior radiographs. If the nodule remains projected over exactly the same rib site despite projectional differences then you can be confident that the lesions is within the rib rather than the lung. 

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Case information

rID: 72512
Published: 27th Nov 2019
Last edited: 28th Nov 2019
System: Chest
Inclusion in quiz mode: Included

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