Described below are points to consider on assessment of bones and soft tissue on chest x-ray.
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ribs
lesions (most commonly metastases): may appear as lucent and/or sclerotic; inverting contrast may help in identification
previous surgery, e.g. thoracotomy with rib resection
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vertebrae
fractures: compression are a common traumatic fracture that can be difficult to identify
lesions: commonly incidental benign (e.g. hemangioma) and less commonly skeletal metastases
pectoral girdle: fractures, distal clavicular erosion, sclerosis
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soft tissue
asymmetric soft tissue may indicate a mastectomy (common), soft tissue mass or Poland syndrome
surgical clips, e.g. lobectomy, pneumonectomy, mastectomy, axillary nodal clearance, thyroidectomy
subcutaneous emphysema and soft tissue injuries