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Anterior chest wall: frequency of anatomic variations in children
L F Donnelly1, D P Frush, J N Foss
1Department of Radiology, Duke University Medical Center, Durham, NC, USA.
Insights
Anterior chest wall variations are common in children, found in one-third of those studied. These findings, including titled sternum and pectus deformities, are considered normal and asymptomatic.
Area of Science:
- Pediatric Radiology
- Anatomy
- Medical Imaging
Background:
- Anterior chest wall variations can be detected using computed tomography (CT).
- Understanding the prevalence of these variations is important for accurate diagnosis.
Purpose of the Study:
- To determine the frequency of anterior chest wall variations in a pediatric population.
Main Methods:
- Retrospective analysis of 200 pediatric chest CT scans.
- Exclusion of patients with prior chest wall surgery or suspected abnormalities.
- Statistical comparison of variation frequency with age and sex.
Main Results:
- One or more anterior chest wall variations were identified in 33% of children.
- Common variations included titled sternum, prominent costal cartilage, and mild pectus deformities.
- No significant association was found between variation frequency, age, or sex.
Conclusions:
- Anterior chest wall variations are frequent in children, occurring in approximately one-third of the population.
- These asymptomatic variations are considered normal findings.
- Palpable variations during physical examination should not cause alarm.
Purpose:
To evaluate the frequency of anterior chest wall variations in children.
Materials And Methods:
The computed tomographic (CT) images of 200 consecutive infants and children (114 boys and 86 girls; mean age, 10.5 years; age range, 3 months to 19 years) who underwent chest CT during a 20-month period were evaluated for chest wall variations. Children who had undergone chest wall surgery or were suspected of having a chest wall abnormality were excluded. The frequency of chest wall anomalies was compared with age and sex (Fisher exact test).
Results:
The CT scans of 65 children (33%) depicted one or more variations in the anterior chest wall: titled sternum (n = 29), prominent convexity of anterior rib or costal cartilage (n = 19), prominent asymmetric costal cartilage (n = 20), well-defined paracostal subcutaneous nodule (n = 4), mild pectus excavatum (n = 4), or mild pectus carinatum (n = 4). The frequency of these findings did not vary significantly with age (P = .96) or sex (P = .36).
Conclusion:
Variations in the anterior chest wall are common, occurring in one-third of children, and should be considered normal. These asymptomatic variations should not be considered alarming when palpated at physical examination.