@theradiologistpage: Male, 20, has an X-ray after trauma but what does it show? 👉 Get my free Chest X-Ray Signs Guide, downloaded by 11,000+ healthcare professionals. Link in bio @theradiologistpage NEUROGENIC TUMOUR 👨🏽‍💻The key to this X-Ray is to remember to use a system! It would be easy to say there is no fracture or dislocation and move on but by reviewing systematically we find an incidental lesion that has implications for the patient 👨🏽‍💻It’s important to assess the lung in all shoulder and clavicle X-Rays - in cases of trauma it is especially important to look for pneumothorax looking for lucency, lack of lung markings and a ‘pleural line’ - a thin white line paralleling the pleural edge 👨🏽‍💻In this case we see an opacity at the apex - in older patients the main differential would be a primary lung cancer however a) this lesion is well defined and b) this is fairly uncommon in this age group so we need to think of other causes 👨🏽‍💻A pleural fibroma would be possible, however this turned out to be a neurogenic tumour (schwannoma). Had the lesion entered the neural foramen then a neurogenic tumour would have been easier to diagnose however we can see the neural foramen is clear on MRI. Lack of foramen involvement doesn’t exclude a neurogenic tumour as this can form anywhere along the intercostal nerve as it has here 👨🏽‍💻Schwannomas are the most common nerve sheath tumour and show high T2 signal on MRI, with heterogeneity due to cystic degeneration/haemorrhage in contrast to fibromas which are typically low in T2 signal however can be heterogenous due to necrosis. Both enhance post contrast 👨🏽‍💻Schwannomas are typically benign but can slowly grow over time Hopefully this case will remind you to assess shoulder and clavicle X-Rays systematically! ——— ☑️ Patient consent obtained

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Thursday 18 June 2026 12:56:00 GMT