{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2024,8,10]],"date-time":"2024-08-10T07:52:34Z","timestamp":1723276354201},"reference-count":38,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2013,6,27]],"date-time":"2013-06-27T00:00:00Z","timestamp":1372291200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Clinical Anatomy"],"published-print":{"date-parts":[[2014,7]]},"abstract":"<jats:p>This article discusses the appearance of the \u201caortic nipple\u201d in chest radiography, and reviews the embryology and anatomy of the left superior intercostal vein which causes the appearance of an \u201caortic nipple.\u201d This radiological sign is useful in differentiating certain thoracic pathologies, such as pneumomediastinum, pneumopericardium, and medial pneumothorax. Pneumomediastinum is an encompassing term describing the presence of air in the mediastinum, and may arise from a wide range of pathological conditions. Despite the well\u2010described imaging of pneumomediastinum, it is sometimes difficult to differentiate from other conditions such as pneumopericardium and medial pneumothorax. A separate finding, \u201caortic nipple\u201d is the radiographic term used to describe the lateral nipple\u2010like projection from the aortic knob present in a small number of individuals. The aortic nipple corresponds to the end\u2010on appearance of the left superior intercostal vein coursing around the aortic knob, and may be mistaken radiologically for lymphadenopathy or a neoplasm. Despite their relative independence, the aortic nipple is defined by new contours in cases of pneumomediastinum, taking on an \u201cinverted aortic nipple\u201d appearance. In this position, the inverted aortic nipple may facilitate radiographic discrimination of pneumomediastinum from similar conditions. This study aims to review the common clinical and radiographic features of both pneumomediastinum and the aortic nipple. The radiologic appearance of the aortic nipple occurring in unison with pneumomediastinum, and its potential role as a tool in the differentiation of pneumomediastinum from similarly presenting conditions will also be described. Clin. Anat. 27:757\u2013763, 2014. \u00a9 2013 Wiley Periodicals, Inc.<\/jats:p>","DOI":"10.1002\/ca.22279","type":"journal-article","created":{"date-parts":[[2013,6,27]],"date-time":"2013-06-27T17:10:59Z","timestamp":1372353059000},"page":"757-763","source":"Crossref","is-referenced-by-count":2,"title":["Pneumomediastinum and the aortic nipple: The clinical relevance of the left superior intercostal vein"],"prefix":"10.1002","volume":"27","author":[{"given":"Andy","family":"Walters","sequence":"first","affiliation":[{"name":"Department of Anatomical Sciences St. George's University, School of Medicine St. George Grenada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lindsey","family":"Cassidy","sequence":"additional","affiliation":[{"name":"Department of Anatomical Sciences St. George's University, School of Medicine St. George Grenada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mitchel","family":"Muhleman","sequence":"additional","affiliation":[{"name":"Department of Anatomical Sciences St. George's University, School of Medicine St. George Grenada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ashley","family":"Peterson","sequence":"additional","affiliation":[{"name":"Department of Anatomical Sciences St. George's University, School of Medicine St. George Grenada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christa","family":"Blaak","sequence":"additional","affiliation":[{"name":"Department of Anatomical Sciences St. George's University, School of Medicine St. George Grenada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marios","family":"Loukas","sequence":"additional","affiliation":[{"name":"Department of Anatomical Sciences St. George's University, School of Medicine St. George Grenada"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2013,6,27]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1259\/bjr\/20497987"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1148\/radiology.144.3.7100455"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1148\/radiographics.20.2.g00mc04309"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.2214\/ajr.166.5.8615238"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00247-010-1760-1"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1136\/hrt.16.4.423"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1378\/chest.87.6.775"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1097\/RTI.0b013e318166d312"},{"key":"e_1_2_10_10_1","first-page":"75","article-title":"Pneumomediastinum: A diagnostic problem","volume":"23","author":"Cyrlak D","year":"1984","journal-title":"Crit Rev Diagn Imaging"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1148\/radiographics.11.2.2028062"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.7863\/jum.2002.21.10.1145"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-34-5-1202"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.2214\/ajr.131.4.599"},{"key":"e_1_2_10_15_1","doi-asserted-by":"publisher","DOI":"10.1378\/chest.60.5.455"},{"key":"e_1_2_10_16_1","first-page":"220","article-title":"A case of left inferior vena cava occurring in a female subject in whom the left superior intercostal vein joined the vena azygos major, and the twelfth ribs were absent","volume":"46","author":"Gladstone RJ","year":"1912","journal-title":"J Anat Physiol"},{"key":"e_1_2_10_17_1","doi-asserted-by":"publisher","DOI":"10.2214\/ajr.147.4.674"},{"key":"e_1_2_10_18_1","first-page":"1","article-title":"Spontaneous mediastinal emphysema","volume":"64","author":"Hamman L","year":"1939","journal-title":"Bull Johns Hopkins Hosp"},{"key":"e_1_2_10_19_1","doi-asserted-by":"publisher","DOI":"10.2214\/ajr.149.2.273"},{"key":"e_1_2_10_20_1","doi-asserted-by":"publisher","DOI":"10.1159\/000029539"},{"key":"e_1_2_10_21_1","first-page":"152","volume-title":"A Treatise on Diseases of the Chest and on Mediate Auscultation","author":"La\u00ebnnec RTH","year":"1834"},{"key":"e_1_2_10_22_1","doi-asserted-by":"publisher","DOI":"10.1148\/120.2.263"},{"key":"e_1_2_10_23_1","doi-asserted-by":"publisher","DOI":"10.1148\/radiographics.22.suppl_1.g02oc05s45"},{"key":"e_1_2_10_24_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejcts.2007.03.008"},{"key":"e_1_2_10_25_1","doi-asserted-by":"publisher","DOI":"10.1001\/archinte.1939.00190050019003"},{"key":"e_1_2_10_26_1","doi-asserted-by":"crossref","first-page":"1447","DOI":"10.1001\/archinte.1984.00350190143024","article-title":"Subcutaneous and mediastinal emphysema. 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