CTICasesRight Lower Lobe Consolidation Adjacent to Vertebral Osteophytes of Uncertain Etiology
Imaging findings
A 49-year-old with end-stage liver disease, a TIPS, and a normal chest CT three months prior, being evaluated for liver transplant, was found on an outside study to have continuous medial right lower lobe consolidation directly abutting large posterior vertebral osteophytes, best appreciated on sagittal reformats. There was no history of trauma and no acute compression fracture; follow-up CT about a month later showed near-complete resolution, leaving only mild linear reticulation and ground glass adjacent to the osteophyte.
Key takeaways
New, transient lung consolidation directly contiguous with prominent vertebral osteophytes and without another explanation (no trauma history, no aspiration risk factor pointing to that exact location) may represent a mechanical or minor hemorrhagic phenomenon related to chronic contact with the osteophyte, though a definitive mechanism was not established in this case; the resolution on short-interval follow-up without any adverse consequence for the patient's transplant candidacy supported a benign, self-limited process rather than malignancy or infection.
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