Sonography of the chest wall: A pictorial essay

Lee, Ryan Ka Lok; Griffith, James F.; Ng, Alex Wing Hung; Sitt, Jacqueline Ching Man

doi:10.1002/jcu.22286

Cited by 19 publications

(29 citation statements)

References 42 publications

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“…In particular, meticulous inspection of the targeted intercostal space for the intercostal artery using Doppler technique is of utmost importance. 4 Ultrasound aids in choosing the biopsy site when pleural involvement is focal. Where there is diffuse pleural involvement, biopsies are usually taken at the midaxillary or posterior axillary lines where the intercostal bundle coursing the space is typically hidden below the above rib.…”

Section: Discussionmentioning

confidence: 99%

A Patient With Effusion Undergoing Pleural Biopsy

Hassan

Rana

Rahman

2018

Chest

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Section: Discussionmentioning

confidence: 99%

A Patient With Effusion Undergoing Pleural Biopsy

Hassan

Rana

Rahman

2018

Chest

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“…Similar to CT, MRI findings demonstrate a fibrofatty lesion, with the fibrous tissue appearing isointense to skeletal muscle on T1- and T2-weighted imaging (Figure 6). Sonographically these lesions appear as echogenic fibroelastic lesions with internal curvilinear streaks of relatively hypoechoic fat [30, 31]. No treatment is required unless the patient is symptomatic.…”

Section: Soft Tissue Lipomatous Lesionsmentioning

confidence: 99%

Imaging review of lipomatous musculoskeletal lesions

Burt

Huang

2017

SICOT-J

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Lipomatous lesions are common musculoskeletal lesions that can arise within the soft tissues, bone, neurovascular structures, and synovium. The majority of these lesions are benign, and many of the benign lesions can be diagnosed by radiologic evaluation. However, radiologic differences between benign and malignant lipomatous lesions may be subtle and pathologic correlation is often needed. The use of sonography, computed tomography (CT), and magnetic resonance imaging (MRI) is useful not only in portraying fat within the lesion, but also for evaluating the presence and extent of soft tissue components. Lipomas make up most soft tissue lipomatous lesions, but careful evaluation must be performed to distinguish these lesions from a low-grade liposarcoma. In addition to the imaging appearance, the location of the lesion and the patient demographics can be utilized to help diagnose other soft tissue lipomatous lesions, such as elastofibroma dorsi, angiolipoma, lipoblastoma, and hibernoma. Osseous lipomatous lesions such as a parosteal lipoma and intraosseous lipoma occur less commonly as their soft tissue counterpart, but are also benign. Neurovascular and synovial lipomatous lesions are much rarer lesions but demonstrate more classic radiologic findings, particularly on MRI. A review of the clinical, radiologic, and pathologic characteristics of these lesions is presented.

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“…The subcutaneous fat forms a lipid coat of varying thickness, lining the entire chest. It is hypoechoic compared to the muscles, and is made up of lobules separated by delicate bands of connective tissue ( 5 , 6 , 9 ) ( Fig. 1 ).…”

Section: Subcutaneous Fat Formsmentioning

confidence: 99%

“…Four major components make up the chest wall, i.e. the skin, subcutaneous fat, a complex assortment of muscles (sometimes referred to as the muscle corset), all supported by cartilages and bones (the ribs, sternum, clavicles, and the sternoclavicular joint) ( 5 , 6 , 9 , 20 ) . The breasts require separate discussion, and as such have not been included in this study.…”

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confidence: 99%

Chest wall – underappreciated structure in sonography. Part I: Examination methodology and ultrasound anatomy

2017

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Chest wall ultrasound has been awarded little interest in the literature, with chest wall anatomy described only in limited extent. The objective of this study has been to discuss the methodology of chest wall ultrasound and the sonographic anatomy of the region to facilitate professional evaluation of this complex structure. The primarily used transducer is a 7–12 MHz linear one. A 3–5 MHz convex (curvilinear) transducer may also be helpful, especially in obese and very muscular patients. Doppler and panoramic imaging options are essential. The indications for chest wall ultrasound include localized pain or lesions found or suspected on imaging with other modalities (conventional radiography, CT, MR or scintigraphy). The investigated pathological condition should be scanned in at least two planes. Sometimes, evaluation during deep breathing permits identification of pathological mobility (e.g. in rib or sternum fractures, slipping rib syndrome). Several structures, closely associated with each other, need to be considered in the evaluation of the chest wall. The skin, which forms a hyperechoic covering, requires a high frequency transducer (20–45 MHz). The subcutaneous fat is characterized by clusters of hypoechoic lobules. Chest muscles have a very complex structure, but their appearance on ultrasound does not differ from the images of muscles located in other anatomical regions. As far as cartilaginous and bony structures of the chest are concerned, the differences in the anatomy of the ribs, sternum, scapula and sternoclavicular joints have been discussed. The rich vascular network which is only fragmentarily accessible for ultrasound assessment has been briefly discussed. A comprehensive evaluation of the chest wall should include the axillary, supraclavicular, apical and parasternal lymph nodes. Their examination requires the use of elastography and contrast-enhanced ultrasound.

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Sonography of the chest wall: A pictorial essay

Cited by 19 publications

References 42 publications

A Patient With Effusion Undergoing Pleural Biopsy

A Patient With Effusion Undergoing Pleural Biopsy

Imaging review of lipomatous musculoskeletal lesions

Chest wall – underappreciated structure in sonography. Part I: Examination methodology and ultrasound anatomy

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