Imaging of chest wall disorders

Pathologic processes that may involve the chest wall include congenital and developmental anomalies, inflammatory and infectious diseases, and soft-ti ssue and bone tumors, Many of these processes have characteristic radiologi c appearances that allow definitive diagnosis, Sternal deformities can be v isualized at radiography and their severity quantified with computed tomogr aphy (CT), In cervical rib, CT with multiplanar reconstruction may demonstr ate relevant anatomic detail and the relationship between bone deformity an d arterial compression, In Poland syndrome, radiography reveals an area of hyperlucency on the affected side, whereas CT demonstrates the absence of t he greater pectoral muscle and clearly depicts associated musculoskeletal a nomalies, Tuberculosis typically manifests at radiography and CT as osseous and cartilaginous destruction and soft-tissue masses with calcification an d rim enhancement, Aspergillosis involving the chest wall manifests as pulm onary consolidations and permeative osteolytic changes of the rib and spine at CT and as an area of increased signal intensity at T2-weighted magnetic resonance (MR) imaging, Neurogenic tumors and hemangiomas also typically h ave high signal intensity at T2-weighted MR imaging, Apparent mass extensio n or unequivocal bone destruction seen at CT or MR imaging may indicate che st wall involvement by lymphoma, Radiologically, soft-tissue sarcomas typic ally appear as areas of soft-tissue density or attenuation, often associate d with necrotic areas of low density or attenuation. At radiography, plasma cytoma typically manifests as well-defined, "punched-out" lytic lesions wit h associated extrapleural soft-tissue masses. Chondrosarcoma frequently app ears as a large, lobulated excrescent mass arising from a rib with scattere d flocculent calcifications characteristic of its cartilaginous mix, Famili arity with these radiologic features facilitates accurate diagnosis and opt imal patient treatment.