ultrasound of the thoracic wall and...
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Ultrasound Ultrasound of of thethe thoracicthoracic wallwallandand axillaaxilla
JeanJean--Yves Meuwly, MDYves Meuwly, MDDepartmentDepartment ofof RadiologyRadiology,, University HospitalUniversity Hospital, , Lausanne, SwitzerlandLausanne, Switzerland
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Abdominal and thoracic wallAbdominal and thoracic wall
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Normal anatomyNormal anatomy
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Normal anatomyNormal anatomy
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ThoracicThoracic wallwall: normal : normal anatomyanatomy
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ThoracicThoracic wallwall: normal : normal anatomyanatomy
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CongenitalCongenital abnormalitiesabnormalities
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Bifide Bifide ribsribs
Rib deformities occur Rib deformities occur in 2.8% of in 2.8% of the the populationpopulation
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InternalInternal mammarymammary lymphlymph nodesnodes
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TumorsTumors of of thethe thoracicthoracic andand abdominal abdominal wallwall
•• BenignBenign–– lipomalipoma–– fibroxantomafibroxantoma–– neurofibromaneurofibroma–– angiomaangioma–– cutaneouscutaneous cystscysts
•• MalignantMalignant–– primaryprimary–– secondarysecondary
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SebaceousSebaceous cystcyst
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SebaceousSebaceous cystcyst
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CutaneousCutaneous tumortumor ??
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TurnTurn on on thethe light !light !
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FibrousFibrous nodulenodule
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LipomaLipoma
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LipomaLipoma
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LymphangiomaLymphangioma
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LymphangiomaLymphangioma
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LymphangiomaLymphangioma
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T2 T1 FS Gado
LymphangiomaLymphangioma
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DesmoidDesmoid tumortumor
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DesmoidDesmoid tumortumor
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PlasmocytomaPlasmocytoma
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PlasmocytomaPlasmocytoma
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MetastasisMetastasis
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MetastasisMetastasis
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LymphomaLymphoma
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TumorTumor Invasion of Invasion of thethe ChestChestWallWall in in LungLung CancerCancer
•• AccuraciesAccuracies of US of US andand CT in a CT in a retrospectiveretrospective studystudy•• 120 patients120 patients•• US US criteriacriteria
–– disruption of pleuradisruption of pleura–– extension extension throughthrough thethe chestchest wallwall–– fixation of fixation of tumortumor duringduring breathingbreathing
•• CT CT criteriacriteria–– obtuse angle of obtuse angle of thethe mass mass withwith thethe wallwall–– > 3 cm contact> 3 cm contact–– visible pleural visible pleural thickeningthickening
Suzuki N,Suzuki N, SaitohSaitoh T,T, KitamuraKitamura SS RadiologyRadiology 1993; 187: 391993; 187: 39--4242
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TumorTumor Invasion of Invasion of thethe ChestChest WallWallin in LungLung CancerCancer
USUS100 %100 %98 %98 %98 %98 %
CTCT68 %68 %SensitivitySensitivity
SpecificitySpecificityAccuracyAccuracy
66 %66 %67 %67 %
Suzuki N,Suzuki N, SaitohSaitoh T,T, KitamuraKitamura SS RadiologyRadiology 1993; 187: 391993; 187: 39--4242
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Small Small pulmonarypulmonary tumortumor
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ThoracicThoracic wallwall Invasion?Invasion?
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Invasion of Invasion of thethe thoracicthoracic wallwall??
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?
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rr
l
ltumor
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TraumaTrauma
Rib fracture, patient with myelopathy
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Sternoclavicular articulationSternoclavicular articulation
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Chondrocostal cartilageChondrocostal cartilage
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Sternocostal, costochondral and Sternocostal, costochondral and interchodral jointsinterchodral joints
Plane synovial joint Plane synovial joint with articular with articular capsulecapsule
FibrousFibrous joint joint without without articular articular capsulecapsule
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CostoCosto--chondralchondral junctionjunction
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Sleeping Sleeping ribrib syndromesyndrome
Meuwly JY, Wicky S, Schnyder P, Lepori D. Slipping rib syndrome: a place for sonography in the diagnosis of a frequently overlooked cause of abdominal or low thoracic pain. J Ultrasound Med 2002; 21:339-343.
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SternoSterno--costal joint abscess costal joint abscess
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AbcessAbcess puncturepuncture
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AxillaAxilla
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Axillary lymph nodeAxillary lymph node
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Axillary lymph nodeAxillary lymph node
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US guided biopsyUS guided biopsy
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Axillary breast tissueAxillary breast tissue
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Axillary breast tissueAxillary breast tissue
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Thank you foryour attention