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(Radiology. 1999;212:837-840.)
© RSNA, 1999

Pediatric Imaging

Anterior Chest Wall: Frequency of Anatomic Variations in Children1

Lane F. Donnelly, MD, Donald P. Frush, MD, Joseph N. Foss, MD 2, Sara M. O'Hara, MD and George S. Bisset, III, MD

1 From the Department of Radiology, Division of Pediatric Radiology, Duke University Medical Center, Durham, NC. From the 1998 RSNA scientific assembly. Received July 28, 1998; revision requested October 15; revision received November 3; accepted March 16, 1999. Address reprint requests to L.F.D., Department of Radiology, Children's Hospital and Medical Center and the University of Cincinnati, 3333 Burnet Ave, Cincinnati, OH 45229-3039.

PURPOSE: To evaluate the frequency of anterior chest wall variations in children.

MATERIALS AND METHODS: The computed tomographic (CT) images of 200 consecutive infants and children (114 boys and 86 girls; mean age, 10.5 years; age range, 3 months to 19 years) who underwent chest CT during a 20-month period were evaluated for chest wall variations. Children who had undergone chest wall surgery or were suspected of having a chest wall abnormality were excluded. The frequency of chest wall anomalies was compared with age and sex (Fisher exact test).

RESULTS: The CT scans of 65 children (33%) depicted one or more variations in the anterior chest wall: tilted sternum (n = 29), prominent convexity of anterior rib or costal cartilage (n = 19), prominent asymmetric costal cartilage (n = 20), well-defined paracostal subcutaneous nodule (n = 4), mild pectus excavatum (n = 4), or mild pectus carinatum (n = 4). The frequency of these findings did not vary significantly with age (P = .96) or sex (P = .36).

CONCLUSION: Variations in the anterior chest wall are common, occurring in one-third of children, and should be considered normal. These asymptomatic variations should not be considered alarming when palpated at physical examination.

Index terms: Thorax, abnormalities, 47.1496, 47.1497, 47.92 • Thorax, CT, 47.1211




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