This title refers to a mat of rusty barbed wire that forms the subject of the image. The index X-ray is difficult to make out – it was segmented to form an archipelago of tiny blotches of colour like a map.The two arches of the thoracic apices are visible. It comes from a person with an extremely painful condition known as Boerhaave syndrome – a tear of the oesophagus usually caused either by surgical instrumentation or a swallowed foreign body and sometimes associated with severe, prolonged vomiting. Occasionally gas leaks into the tissues around the heart and great vessels. Infection especially with gas-producing bacteria may also occur.
The image includes a South African aloe in flower. I have linked the injuries from barbed wire and spiky aloe thorns with the medical condition to produce this picture.