Epicardial Fat Pad: A Chest Radiograph Pitfall Every Radiologist Should Know

Epicardial fat pad is a normal variant, most commonly at the right cardiophrenic angle, that can mimic cardiomegaly or a mediastinal mass on chest radiographs. Recognizing its characteristic smooth, non-calcified appearance prevents unnecessary follow-up imaging.

• This educational post from LearningRadiology reviews the epicardial fat pad, a benign collection of pericardial fat often mistaken for pathology.
• It typically appears as a well-defined, non-calcified opacity at the cardiophrenic angle and is stable over serial exams.
• Key for trainees and board preparation: differentiate from true masses using location, fat density on CT, and unchanged interval appearance.

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