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Is there an abnormality present?
No. However, there are bilateral lower zone nipple shadows, which can be mistaken for pathology such as a pulmonary nodules.
How can you be sure they are nipple shadows?
Firstly, they are bilateral and in the typical position. To problem solve you can compare with previous chest x-rays or repeat the chest x-ray with nipple markers.
Heart size is within normal limits. Lungs and pleural spaces are normal. Bilateral nipple shadows noted.