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The troublesome nipple shadow.

W T Miller, J M Aronchick, D M Epstein

    AJR. American Journal of Roentgenology
    |September 1, 1985
    PubMed
    Summary
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    Radiologists sometimes misidentify nipple shadows on chest X-rays, potentially leading to unnecessary follow-up exams. Using lead markers to identify nipples on all patients eliminates this uncertainty and need for repeat imaging.

    Area of Science:

    • Radiology
    • Medical Imaging
    • Diagnostic Procedures

    Background:

    • Nipple shadows are frequently visible on routine chest examinations.
    • Misidentification of nipple shadows can lead to diagnostic uncertainty and unnecessary repeat imaging.
    • Current methods for nipple identification lack consistent certainty.

    Purpose of the Study:

    • To evaluate the frequency of nipple visibility and misidentification on chest X-rays.
    • To assess the effectiveness of lead markers in improving nipple identification certainty.
    • To determine if lead markers reduce the need for repeat chest examinations.

    Main Methods:

    • Review of 1000 routine chest examinations to assess nipple visibility and radiologist uncertainty.
    • Analysis of 14 instances where radiologists suspected nipple misidentification.

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  • Implementation of lead markers for nipple identification in a separate group of 500 patients.

    • Main Results:

    • Nipples were visible in approximately 10% of chest examinations.
    • Radiologists noted uncertainty in 1.4% of cases, with 4 instances of actual misidentification.
    • Lead markers eliminated uncertainty and the need for repeat examinations in the second patient group.

    Conclusions:

    • Nipple shadows can cause diagnostic ambiguity on chest X-rays.
    • Lead markers provide a simple, cost-effective solution for certain nipple identification.
    • This technique enhances diagnostic accuracy and patient convenience by preventing unnecessary repeat imaging.