Ultrasound Ultrasound of of the the thoracic thoracic wall wall and and axilla axilla Jean Jean - - Yves Meuwly, MD Yves Meuwly, MD Department Department of of Radiology Radiology , , University Hospital University Hospital , , Lausanne, Switzerland Lausanne, Switzerland
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Ultrasound Ultrasound of of thethe thoracicthoracic wallwallandand axillaaxilla
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??
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.