A 34 year old lady presents following a mechanical fall onto pavement. She presents to ED complaining of left sided chest pain.
Describe and interpret this CXR
CHEST X-RAY INTERPRETATION
There are rib fractures of the 7th and 8th ribs posteriorly on the left side. There is a healed / healing fracture of the right 5th rib.
On the lateral aspect of the left upper zone there is a rounded partially calcified lesion in continuity with the 2nd rib.
Bilateral nipple shadows. Clear pleura and lung parenchyma.
This lady has fibrodysplasia ossificans progressiva.
Multiple low trauma rib fractures might suggest an underlying connective tissue disorder.
The odd lesion in the left upper zone is likely heterotropic ossification after trauma.
Fibrodysplasia ossificans is a very rare heritable disorder characterized by congenital malformation of the great toes, heterotropic ossification and sometimes progressive chest wall deformity with kyphoscoliosis and ventilatory failure causing type II respiratory failure.