Companion shadow

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AP radiograph demonstrating companion shadow of the clavicle
A rib companion shadow (indicated by two arrows)

Companion shadow is a term used in describing radiographs that denotes the appearance of a smooth, homogenous, radiodensity with a well-defined margin that runs parallel with a bony landmark. Companion shadows represent soft tissue that overlies the respective bony landmark in profile. They are not seen in every radiograph and can be misinterpreted as pathology.

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