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A man in his 60s who had recently moved to the area attended a preoperative appointment for a cholecystectomy. He reported to be asymptomatic. He had a past medical history of hypertension and took Amlodipine and had no known allergies. A chest X-ray was performed as part of the workup (figure 1).
What is the cause of abnormalities seen on the image?
Prominent pericardial fat pad only
Bilateral healed rib fractures
The correct answer is D, as there is evidence of bilateral inferior rib notching (online supplemental figure 1—white chevron) as well as an absent aortic knuckle (online supplemental figure 1 …
Contributors MS and BR came up with the concept and prepared the manuscript.
Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.
Competing interests None declared.
Provenance and peer review Not commissioned; internally peer reviewed.
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