Clinics in diagnostic imaging (100). Migrated pharyngeal fish bone

A 71-year-old man presented with a suspected swallowed fish bone. The lateral radiograph of the neck showed a curvilinear radio-opaque density in the swollen pre-vertebral soft tissues. The diagnosis of a migrated fish bone was confirmed on computed tomography and during subsequent surgery. The patient made a good recovery. As calcified normal structures, particularly the laryngeal cartilages, can mimic abnormal radio-opaque foreign bodies, it is important to be able to recognise the normal calcified structures seen on the neck radiograph. A sound knowledge of radiological anatomy is required in order to avoid unnecessary investigation and to provide prompt and appropriate management.