Anterior Chest Wall: Frequency of Anatomic Variations in Children1
Lane F. Donnelly, MD,
Donald P. Frush, MD,
Joseph N. Foss, MD 2,
Sara M. O'Hara, MD and
George S. Bisset, III, MD
1 From the Department of Radiology, Division of Pediatric Radiology, Duke University Medical Center, Durham, NC. From the 1998 RSNA scientific assembly. Received July 28, 1998; revision requested October 15; revision received November 3; accepted March 16, 1999. Address reprint requests to L.F.D., Department of Radiology, Children's Hospital and Medical Center and the University of Cincinnati, 3333 Burnet Ave, Cincinnati, OH 45229-3039.
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Figure 1a. Tilted sternum with associated subluxation of the left clavicular head in a 12-year-old girl. (a) Axial CT image shows the sternum (arrow) to be tilted with respect to the horizontal right-to-left axis of the body. The left margin of the sternum is located more anteriorly than the right margin. (b) Shaded-surface three-dimensional CT reconstructed image, obtained for illustrative purposes, shows tilted sternum (arrow) and anteriorly subluxated left clavicular head (arrowhead). The image is displayed as viewed in the axial plane, from the superior perspective, with the anterior region located at the top and the posterior region at the bottom of the image.
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Figure 1b. Tilted sternum with associated subluxation of the left clavicular head in a 12-year-old girl. (a) Axial CT image shows the sternum (arrow) to be tilted with respect to the horizontal right-to-left axis of the body. The left margin of the sternum is located more anteriorly than the right margin. (b) Shaded-surface three-dimensional CT reconstructed image, obtained for illustrative purposes, shows tilted sternum (arrow) and anteriorly subluxated left clavicular head (arrowhead). The image is displayed as viewed in the axial plane, from the superior perspective, with the anterior region located at the top and the posterior region at the bottom of the image.
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Figure 2. Right prominent anterior convex costal cartilage and left prominent costal cartilage size in a 9-year-old girl. Axial CT scan shows prominence of the anterior convexity of the right costal cartilage (arrow) and asymmetrically larger left costal cartilage (arrowhead).
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Figure 3. Small parachondral nodule in a 16-year-old boy. Axial CT scan shows a small (3-mm-diameter) nodule (arrow) in subcutaneous tissues immediately adjacent to the costal cartilage. Such nodules are believed to represent cartilaginous islands (1).
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Figure 4. Pectus excavatum in a 7-year-old girl. Axial CT scan shows anterior chest wall to be concave. The midline chest wall (arrow) is located more posteriorly than the more lateral chest wall.
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Figure 5. Pectus carinatum in a 13-year-old boy. Axial CT scan shows apex anterior convexity of anterior chest. The midline chest wall (arrow) is located more anteriorly than the more lateral chest wall. The left hemidiaphragm is elevated secondary to acute phrenic nerve involvement by mediastinal lymphoma. The high-attenuation linear structure in the subcutaneous tissues of the right anterior chest wall represents a central venous catheter.
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Copyright © 1999 by the Radiological Society of North America.
