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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
Abdominal and thoracic wallAbdominal and thoracic wall
Normal anatomyNormal anatomy
Normal anatomyNormal anatomy
ThoracicThoracic wallwall: normal : normal anatomyanatomy
ThoracicThoracic wallwall: normal : normal anatomyanatomy
CongenitalCongenital abnormalitiesabnormalities
Bifide Bifide ribsribs
Rib deformities occur Rib deformities occur in 2.8% of in 2.8% of the the populationpopulation
InternalInternal mammarymammary lymphlymph nodesnodes
TumorsTumors of of thethe thoracicthoracic andand abdominal abdominal wallwall
•• BenignBenign–– lipomalipoma–– fibroxantomafibroxantoma–– neurofibromaneurofibroma–– angiomaangioma–– cutaneouscutaneous cystscysts
•• MalignantMalignant–– primaryprimary–– secondarysecondary
SebaceousSebaceous cystcyst
SebaceousSebaceous cystcyst
CutaneousCutaneous tumortumor ??
TurnTurn on on thethe light !light !
FibrousFibrous nodulenodule
LipomaLipoma
LipomaLipoma
LymphangiomaLymphangioma
LymphangiomaLymphangioma
LymphangiomaLymphangioma
T2 T1 FS Gado
LymphangiomaLymphangioma
DesmoidDesmoid tumortumor
DesmoidDesmoid tumortumor
PlasmocytomaPlasmocytoma
PlasmocytomaPlasmocytoma
MetastasisMetastasis
MetastasisMetastasis
LymphomaLymphoma
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
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
Small Small pulmonarypulmonary tumortumor
ThoracicThoracic wallwall Invasion?Invasion?
Invasion of Invasion of thethe thoracicthoracic wallwall??
?
rr
l
ltumor
TraumaTrauma
Rib fracture, patient with myelopathy
Sternoclavicular articulationSternoclavicular articulation
Chondrocostal cartilageChondrocostal cartilage
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
CostoCosto--chondralchondral junctionjunction
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.
SternoSterno--costal joint abscess costal joint abscess
AbcessAbcess puncturepuncture
AxillaAxilla
Axillary lymph nodeAxillary lymph node
Axillary lymph nodeAxillary lymph node
US guided biopsyUS guided biopsy
Axillary breast tissueAxillary breast tissue
Axillary breast tissueAxillary breast tissue
Thank you foryour attention