It’s just contrast. Here is my own CTA imaging showing the same thing:
If it were actually calcification of anything it would show in your CT without contrast as well.
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I’m signing off, but I ran the other images through and it was consistent. Independent of opinions, it seems logical to run with it — I’ve found more than once that one finding can lead to another helpful diagnosis.
Across the different CT slices and the 3D reconstruction, there are clearly small, sharply marginated high-density foci in the costoclavicular ligament region. These don’t follow the pattern of vascular contrast — they are extra-vascular, structured, and appear exactly where the ligament anchors between the clavicle and first rib.
This is consistent with ligamentous or enthesopathic calcification. While uncommon in someone young, it’s a real finding and not just “contrast faking bone.” Calcification always shows as bright on CT, with or without contrast — what changes is how visible it looks depending on slice thickness, windowing, and whether it’s highlighted in 3D reconstruction.
Why it matters: the costoclavicular space is where the subclavian vein, artery, and brachial plexus pass. Even a small calcified ligament can contribute to narrowing and thoracic outlet compression. If there are symptoms like arm pain, numbness, swelling, or vascular changes, this finding is definitely worth being taken seriously.
This isn’t something to dismiss — it’s something to have evaluated further, ideally with a radiologist or vascular/orthopedic specialist who can review the entire dataset, correlate with symptoms, and determine if it needs follow-up imaging or management.
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You’re dumbing this down into something it isn’t. CT findings aren’t judged off one slice — visibility depends on things like slice thickness, window settings, and reconstruction. That’s why a subtle calcification can look faint on one series but show up clearly on another or on 3D. Contrast doesn’t “create fake bones,” and writing it off like that risks people missing something real.
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But why can’t they see the “bones” or “calcifications” in their CT that didn’t have contrast? You’re not speaking to that crucial piece
Don’t get me wrong, they definitely should consider the possibility of everything, but you should be able to see those calcifications in the other CT too.
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Because CT isn’t that simple. Visibility isn’t just “on or off” — it depends on slice thickness, window settings, and reconstruction. A small calcification can blend into surrounding tissue on one study but stand out on another or in 3D. That doesn’t mean it’s not there — it means you have to look at the whole dataset, not just one slice.
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Well I hope you’re right cause that would be a potentially easy fix to get rid of some symptoms!
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I’m not saying it’s definite its just that it’s a potential differential diagnosis that shouldn’t be dismissed. And sometimes even one small step forward can lead to unexpected clarity and resolution.
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Yea it’s not bone, the question is if this is some sort of venous malformation or simply just contrast
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Can you use the measure tool and tell me the hu measurement by chance? Mine was 2000+ mean
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In others words can you click down your middle mouse button and scroll up and down. Does it fade away with the rest of your artery\veins or persist along side your bones. Also in the top put it in “bone view”
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I’ll check tomorrow when I get on my laptop!
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That was an interesting discussion, & I have to side w/ @MGORNEAU in that if there is ANY possibility that what the 3D image shows is actually there, it shouldn’t be ignored i.e. a follow-up discussion with the appropriate type of specialist would be a really good idea even if the proposed calcification is ultimately dismissed.
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Thank you! Also check if ur 3d reconstruction has it as a bone please
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@6tdog6 Yup mine shows it’s bone too even though it’s just contrast. The contrast clumping like that has to do with the venous phase of when the CT images are taken in respect to when the contrast was injected. Based on my research this contrast issue on the left side of the body usually occurs when the contrast is injected into the left arm, and has to do with the venous phase.
And in reality, this would be an issue on the side of RadiantViewer in not accurately differentiating bone/calcification from contrast.
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