Imaging Case of the Week 506 Answer

The x-ray does not show any acute fractures. Faint lucency across upper scapula turned out to be not related to fracture.

The x-ray does show an expansile lesion on the posterior aspect of 5th rib (incidental finding).

Differentials include primary bone lesion, metastatic lesion, hematological malignancy (myeloma deposits).

CT scan of the chest confirmed the lesion to be a benign one.

Pay attention to all the structures seen on imaging rather than looking for only those findings related to clinical question (? fracture related to trauma in the above case).