Plain film radiography of the chest: findings that simulate pulmonary disease

Many pitfalls are encountered while interpreting routine radiographs of the chest. Intrathoracic disease can be mimicked by disease or anatomic variation of the superimposed bony thorax and soft tissues, by artifacts, and by iatrogenic intrathoracic changes. Although cross-sectional imaging may occasionally be necessary to solve a problem case, most often the simple use of an additional projection such as a lordotic, kyphotic, oblique, or skin marker view is sufficient to exclude pulmonary disease. We illustrate a series of cases in which serious intrathoracic disease was mimicked by extrapulmonary processes. The correct interpretation of these findings in a timely manner with relatively simple and inexpensive maneuvers can save the patient unnecessary worry and expense.