Rib metastasis - exam film

Discussion:

This is a classic exam film and also one which either gives us either delight or angst depending on if one spotted or missed this finding.

It is a so called 'edge case' with the findings being on the film, but not part of the anatomy chiefly being interrogated.

It teaches us the need to review the whole film.

The lesion is more advance and apparent on the subsequent chest x-ray, however this also could potentially be missed with a heavy workload, reporting at speed.

This was the patient's presenting complain and film for what subsequently turned out to be metastatic breast cancer.

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