An Immigrant medical X ray for excluding primarily Tuberculosis shows a summation of soft tissue opacities along superior border of clavicle and inferolateral border of 1st and 2nd ribs on right mimicking an abnormal etiology which includes fissure, pleural tags or fibrotic streaks.
Teaching points by Dr MGK Murthy, Dr Prasanna
- Companion shadows accompany bones and can be bothersome in differentials in chest . They are produced by soft tissues accompanying the bones and become visible or prominent depending on being tangential to the X ray beam
- Ribs, Clavicle, Scapulae (particularly medial border) are the usual places of occurrence with occasional presence among the lower ribs. In case of any difficulty ,Lordotic projections, lateral view or cross sectional imaging would help
Companion Shadows-CXR Reviewed by Sumer Sethi on Thursday, March 26, 2015 Rating: