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Silent anatomic variations of the pediatric chest: They might not be congenital
1Department of Pediatric Radiology, Van Training and Research Hospital, Van, Turkey.
Insights
Silent chest wall variations are common in children, increasing with age. These asymptomatic findings are typically benign and developmental, not requiring further imaging.
Area of Science:
- Pediatric Radiology
- Thoracic Imaging
- Anatomical Variations
Background:
- Chest wall anatomical variations are frequently encountered in pediatric imaging.
- Understanding the prevalence and age-related changes of these variations is crucial for accurate diagnosis.
Purpose of the Study:
- To determine the prevalence of silent chest wall anatomical variations in children.
- To assess the frequency of these variations across different age groups.
- To investigate if chest wall variations become more prominent with increasing age.
Main Methods:
- Retrospective review of 510 pediatric Thorax CT scans.
- Exclusion of patients with known chest wall deformities, lesions, or trauma.
- Evaluation and comparison of silent variation frequency by age and sex.
Main Results:
- 23.1% of patients exhibited silent chest wall variations.
- Prominent costal cartilage convexity was the most frequent variation (30.5% of variations).
- A statistically significant increase in variation frequency was observed with age (p < 0.001).
Conclusions:
- Asymptomatic chest wall asymmetries are common and generally benign, negating the need for further imaging.
- The increased prevalence with age supports a developmental etiology over a congenital one.
- These variations become more pronounced during growth, highlighting their developmental nature.
Aim:
We aimed to evaluate the prevalence of silent anatomic variations of the chest wall, to estimate frequency in different age groups, and to answer are these variations more prominent with age?
Materials And Methods:
Thorax CT scans of 592 children were retrospectively reviewed. 82 children who underwent CT for evaluation of the suspected chest wall deformities, chest wall lesions, prominent scoliosis, and who had chest wall surgery, thoracotomy, or trauma causing chest wall or clavicular fracture were excluded from the study. The frequency of silent anatomic variations was evaluated and compared with age subgroups and sex.
Results:
118 of 510 patients had variations of the chest wall (23.1%). The most common silent variation was the prominent convexity of the costal cartilage (n = 36, 30.5% of the variations). A significant difference existed in the frequency of variations between age subgroups (p < 0.001).
Conclusion:
A high rate of silent variations indicates that asymptomatic asymmetries of the chest wall are mostly benign and there is no need for further imaging. An increase in the frequency of the variations with age supports the hypothesis that these findings are mostly developmental instead of congenital and become more prominent with growth.
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