Clavicle – ChestDB.com

Case 60

ICU/Surgery / Age 31-60, Cholecystectomy, Clavicle, Claviculectomy, Stent, Subclavian Vein Stent, Thoracic Outlet Syndrome

This radiograph shows a patient with a left claviculectomy for venous thoracic outlet syndrome. This is an uncommon surgical treatment for this condition, with first rib resection being more common. In some cases a clavicle fracture with subsequent malunion or nonunion can case thoracic outlet syndrome and can be treated with claviculectomy or corrective clavicle osteotomy. A left subclavian venous stent is also in place, another possible treatment for venous thoracic outlet syndrome.

Surgical clips are seen in the right upper quadrant, most likely from cholecystectomy. Two surgical clips are also present in the left breast. The exam is otherwise unremarkable.

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Case 57

Normal/Variants & Congenital / Age 31-60, Clavicle, Cleidocranial Dysplasia, Congenital, Nerve Stimulator, Unfused Spinous Process

This radiograph shows a patient with cleidocranial dysplasia. The right clavicle is entirely absent and the left clavicle is severely hypoplastic. The shoulders are depressed bilaterally due to lack of articulation with the axial skeleton. Metallic foreign objects projecting of the left acromion process are most likely retained nerve stimulator leads. Unfused spinous processes are seen in the lower cervical and upper thoracic spine.

The remainder of the exam is unremarkable.

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Case 18

Emergency & Trauma, Infectious/Inflammatory / Age <30, Aspiration, Clavicle, Consolidation, Endotracheal Tube, Enteric Tube, Esophageal Temperature Probe, Fracture, Portable

This radiograph shows hazy consolidation in the right lung base, with more subtle left lower lobe consolidation projecting over the heart. There is a displaced left mid-clavicular fracture. Lines and tubes include an endotracheal tube, an enteric tube, and an esophageal temperature probe which are all appropriately positioned. The distribution is typical for aspiration, with or without infection. Contusion is also a consideration in a trauma patient. In this case, the EMS report included witnessed aspiration which makes it the most likely etiology.

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