A pictorial essay of thoracic wall diseases: multiple pathologies in the same anatomical site

To describe diagnostic and radiological features of the main pathologies affecting the thoracic wall, providing a pictorial atlas based on several clinical cases extracted from our archive.

A wide variety of pathologies affect the tissues of the thoracic cage; these conditions are often encountered by radiologists during examinations performed for unrelated clinical questions. Modern imaging techniques enable the detection of these pathologies and allow definitive diagnoses to be achieved.

Pathological processes that involve the chest wall may be classified into: (1) congenital and developmental diseases: pectus excavatum, pectus carinatum, supernumerary rib syndrome, Poland syndrome, neurofibromatosis, osteogenesis imperfecta, mucopolysaccharidosis, Marfan syndrome; (2) infectious and inflammatory diseases-such as aspergillosis, tuberculosis, abscesses from pyogenic bacteria, Tietze's syndrome; (3) bone injuries (traumatic and degenerative diseases): sternal, vertebral and costal fractures, degenerative disc and arthrosis pathology; (4) chest wall tumors-such as sarcomas, lymphomas, neurogenic tumors, lipoma.

Thoracic wall pathologies include a wide spectrum of conditions, with some clinical implications that often require a correct nosological framing. Recognizing these pathologies is essential for radiologists so that they can make a correct description in the report and direct toward appropriate treatment if required.

Cage diseases are various and difficult to understand, so multimodality imaging plays a crucial role in achieving an efficient and final diagnosis.

Thoracic wall pathologies have different etiologies. Imaging represents a fundamental tool to clarify their extension, location, and nature. The prognosis of some of these diseases can be poor.