This article shows the chest radiograph of a thirteen-year-old male. The study demonstrates bilateral notching
of the inferior borders of the 3rd-8th posterior ribs, a finding associated with coarctation of the aorta.
Blood bypasses the aortic narrowing through intercostal collaterals, which enlarge to accommodate
the increased flow rates. The pulsations of these vessels cause disruption to bone remodelling
leading to the characteristic notching.peer-reviewe
