Anatomical Landmarks: Lines and Stripes

Chest radiography is considered the first level imaging examination for the evaluation of thoracic structures; it is performed daily in all hospital facilities on a large patient population. The role of the chest radiogram in the diagnostic pathway of a patient with acute chest pain or suspected acute aortic syndrome is limited, as emphasized by the European Society of Cardiology guidelines on acute chest pain management and aortic pathology. However, in clinical practice, the chest X-ray is commonly used as a first level investigation, especially in the preliminary phases of clinical evaluation of patients presenting to the DEA. It is therefore essential for the radiologist to be able to recognize those radiological findings that, even if with low sensitivity and specificity, can lead to the suspicion of aortic pathology. Above all, it is mandatory to recognize radiological findings that can be found in acute aortic syndrome.