3] Assessment of the Film
3.6] Chest Wall
When assessing the chest wall, there are a number of factors to look at. Here are some examples of things you may see.
Breast shadows
Breast shadows maybe Asymmetric or absent post surgery.
Please note a single breast shadow in this female patient who has had a right mastectomy.
Nipple shadows
Here is an example of nipple shadows seen on a CXR. They typically have one sharp margin and one poorly defined margin and caused by air trapping.
Hair artefact
Here is an example of hair artefact often seen on CXR’s. It is important to recognise, so as not to mistake it for pathology.
Bone lesions
It is important to review the whole film, looking at the ribs and the vertebral bodies. Don’t forget to look at the edges of the film particularly at the humeral heads to look for fractures or other pathology.
Chest wall masses
Here is an example of a soft tissue right chest wall mass. The right 6th rib laterally is displaced due to the mass. This was found to be a rhabdomyosarcoma of the chest wall.
