A patient comes in for a musculoskeletal complaint, imaging is ordered or reviewed, and the finding that matters most is not where anyone expected it to be. That is the core lesson from the case report by Ibis Melissa Roman Guzman, DC, and Jake Halverson, DC, describing focal nodular hyperplasia of the liver found incidentally in a 35-year-old chiropractic patient with rib pain. Cases like this sit at the intersection of everyday clinical care and diagnostic vigilance.