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Companion Shadows-CXR

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: 5

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