At one stage my cardiothoracic unit provided a service to a local general hospital in bone scaning. This patient was referred by an orthopoedic surgeon for evaluation of persistent left chest pain. Seeing the hot spots on the left lower ribs, I remembered that I was a doctor and did a history and examination. Lo and behold she had a recent sternotomy, done in my own hospital! I ordered a plain films of the chest, and got out the most recent post op film.
Quite a change! The inference that the chest pain was something to do with the heart led naturally to a CT (below) which confirmed a false aneurysm of the left ventricle. The rib pain was due to early erosion by the aneurysm.
