Ultrasound of the thoracic wall: in the first-line of diagnosis

Congress:

ECR 2018

Poster Number:

C-1046

Type:

Educational Exhibit

Keywords:

Education and training, Education, Ultrasound, Thorax, Musculoskeletal system

Authors:

M. del Amo, I. Vollmer, J. Pomes, X. Tomás, A. I. Garcia Diez, I. Pomes, A. Soler Perromat, C. Perez; Barcelona/ES

DOI:

10.1594/ecr2018/C-1046

DOI-Link:

https://dx.doi.org/10.1594/ecr2018/C-1046

Fig. 1: Panoramic ultrasound image obtained in the cranio-caudal direction showing the...

Fig. 2: Images of a Power-Doppler US study showing less quantity of vessels in image B...

Fig. 3: A: Skin. B: Subcutaneous fatty tissue. C: Muscle

Fig. 4: A: Pectoralis major (1) and minor (2). B: latissimus dorsi (3) and serratus...

Learning objectives

In the study of the pathology of the thoracic wall, ultrasound is, increasingly, a good diagnostic option for the assessment of different structures and their pathology. Our objectives are: . To describe normal sonographic anatomy of the chest wall and its ultrasound study. . To show a wide range of indications of ultrasound study of the thoracic wall pathology with images and videos.

Background

Chest wall pathology frequently requires imaging studies. X-Ray is usually the first exploration in chest trauma or in cases with nonspecific thoracic symptoms, but has important limitations in soft-tissue lesions or detecting rib or cartilage fractures. The ultrasound study (US) offers many advantages, because it’s a safe exploration, simple and fast, the anatomical structures to study are very superficial, requires few technical requirements (high frequency transducer, panoramic images, Power-Doppler US and possibility of recorded videos) and it’s a technique that has high sensitivity in the...

Findings and procedure details

TECHNIQUE To perform the ultrasound study of the thoracic wall, the position of the patient depends on the location of the symptoms or suspicion of pathology, so he could be placed in the supine, prone or lateral position or even sitting. The ultrasound study is performed using a high frequency linear-array transducer (10-14 MHz) for the most superficial structures and only in deep structures or obese patients with lower frequency probes (5-10 MHz). Another interesting tool in the study of the thoracic wall is the...

Conclusion

US is very useful in the study of most pathologies and symptoms of the chest walland that, in most cases, is the firstchoice of study to perform, and thereforeshould be considered a first-line diagnostic tool that the radiologist should know.

Personal information

References

1. Lee RK, Griffith JF, Ng AW, Sitt JC. Sonography of the Chest Wall: A Pictorial Essay. J Clin Ultrasound. 2015 Nov-Dec;43(9):525-37 2. Griffith JF, Rainer TH, Ching AS, et al. Sonography compared with radiography in revealing acute rib fracture. AJR Am J Roentgenol 1999;173:1603. 3. Donnelly LF, Frush DP, Foss JN, et al. Anterior chest wall: frequency of anatomic variations in children. Radiology 1999;212:837. 4. Donnelly LF, Frush DP. Abnormalities of the chest wall in pediatric patients. AJR Am J Roentgenol 1999;173:1595. 5. Paik...