Thoracic deformity

Introduction

Introduction to thoracic deformity The deformity of the sternum forward bulge. After the incidence of funnel chest, it is the second most common disease in chest wall malformation. Most scholars believe that the ribs and costal cartilage are overgrowth, and the sternum deformity is secondary to rib deformity. As genetically related to the funnel chest, these are two common thoracic deformities. basic knowledge The proportion of sickness: 0.01% Susceptible people: no special people Mode of infection: non-infectious Complications: upper respiratory tract infection bronchial asthma

Cause

Cause of thoracic deformity

Thoracic deformities can be caused by intrathoracic or systemic diseases or by congenital causes.

1. Thoracic deformity caused by thoracic disorders

Often caused by acute, chronic inflammation or tumors in the ribs, costal cartilage, spine, and chest wall. Such as rib fractures, costal cartilage inflammation, thoracic tuberculosis, benign and malignant tumors of the chest wall and thoracic trauma.

2. Thoracic deformity caused by pleural disease

Pleural effusion, pneumothorax can make the thoracic (affected side) full; extensive pleural adhesion, hypertrophy when the thoracic collapse; pleural mesothelioma makes the thoracic deformity full.

3. Thoracic deformity caused by respiratory diseases

Extensive fibrosis of the lungs, atelectasis, emphysema, etc. can cause malformation, collapse or bulging of the thorax as a whole or in part. Lung cancer may be accompanied by alveolar dysplasia, emphysema or metastasis to the pleura and ribs.

4. Thoracic deformity caused by circulatory diseases

Cardiac enlargement, pericardial effusion, aortic aneurysm, constrictive pericarditis, etc. can cause local thoracic deformity.

5, thoracic deformity caused by lack of nutrition

Lack of vitamin D in children can cause rickets;

When calcium and phosphorus are deficient, the bone cannot be calcified, and thoracic deformity may occur.

Prevention

Thoracic deformity prevention

Early detection and early treatment.

Complication

Thoracic deformity complications Complications upper respiratory tract infection bronchial asthma

In severe cases, the thoracic changes, squeezing the heart and lungs, severely affect the cardiopulmonary function, resulting in corresponding clinical symptoms, and more often associated with comorbidities. For example, in combination with Marfan syndrome and neurofibromatosis, complications of respiratory system such as repeated upper respiratory tract infection and bronchial wheezing often occur in patients with severe chicken thorax.

Symptom

Symptoms of thoracic deformity Common symptoms Barrel chest heart enlargement Pulmonary fibrosis Pleural adhesion rib fusion Ventricular stenosis Lung infidelity Pneumothorax

1, barrel chest

More common in asthma, chronic bronchitis and other emphysema, can also be seen in elderly and short-skinned people. The anteroposterior diameter and the left and right diameter of the thorax are increased, especially the anteroposterior diameter is significantly increased, sometimes equal to the left and right diameters, so that the chest is barrel-shaped.

2, flat chest

Found in chronic wasting diseases such as tuberculosis, can also be seen in patients with elongated body shape, flat thoracic, small anteroposterior diameter and often shorter than half of the left and right diameter; prominent clavicle, obvious upper and lower fossa, rib sag, small intercostal space.

3, funnel chest

The funnel chest is a funnel-shaped thoracic deformity in the lower part of the sternum and the xiphoid. The lower thorax of the patient is flat, and the sternal angle collapses to the rear. The xiphoid is most obvious. The distance between the lower end of the sternum and the spine is shortened. The ribs on both sides of the sternum are curved, and may be associated with posterior vertebral protrusion or other deformities.

4, chicken breast

Because of rickets, repeated respiratory infections in childhood can also cause chicken breasts. The chest of the chicken chest is protruding forward, especially the lower part. The anteroposterior diameter of the thorax is enlarged, the transverse diameter is reduced, and the rib cage cartilage is often accompanied by one or both sides; the joint between the rib and the costal cartilage is enlarged and thickened, and is beaded.

5, spinal deformity

There are many causes, due to congenital dysplasia accompanied by vertebral deformity, or secondary to tuberculosis, rickets, osteomalacia, trauma, neuromuscular lesions and severe pleural thickening, thoracoplasty, etc., but most of the causes are unknown. The disease is caused by the thoracic vertebrae bending backward and backward to cause thoracic deformity. In severe cases, the rib space on the convex side of the spine is obviously widened, and the thoracic bulge is raised.

Examine

Thoracic deformity examination

1. X-ray: The chest X-ray shows that the lower part of the sternum and the adjacent costal cartilage are obviously sunken, and the distance between the spine and the sternum is increased. X-ray of the spine to observe the presence or absence of lateral curvature of the spine.

2, CT scan: CT scan can more accurately evaluate the extent, symmetry, heart and lung effects of chicken breast and other problems. Such as combined with cystic adenomatoid malformation, isolation of the lungs, sputum swelling and so on.

3, ECG: Occasionally sinus arrhythmia, not complete right bundle branch block.

4, heart, lung function check: very severe cases of heart and lung function decline.

5, blood biochemistry: some patients have mild anemia and serum alkaline phosphatase increased.

Diagnosis

Diagnosis and diagnosis of thoracic deformity

Thoracic collapse: One side of the thoracic collapse can be caused by empyema or pleurisy, extensive pleural thickening adhesions and contractions, atelectasis, pulmonary fibrosis, chronic fibrotic tuberculosis, chronic lung suppuration and other diseases. The clinical manifestations vary with the primary disease. The trachea moves to the affected side, the thoracic contour of the affected side becomes smaller, and the common scoliosis of the spine is common.

The thoracic stenosis and flatness: juvenile vertebral osteochondrosis, hunchback as the main symptom, with spinal rigidity. The neck often flexes, the shoulders are drooping, the thoracic cage is narrow and flat, and the shoulder blades are prominent.

Thoracic dysplasia syndrome: refers to the chest can not support normal breathing and lung growth. TIS is a collective term for a class of syndromes. Most of these diseases are congenital diseases, and there are multiple system malformations. The most common are congenital scoliosis and congenital lateral kyphosis. Patients with congenital spinal deformity usually have ribs and ribs. Absence of thoracic developmental malformations. TIS can be divided into four types: type I is rib absent and scoliosis, type II is rib fusion and scoliosis, type IIIa is a small chest, and type IIIb is a narrow thorax.

Children's thoracic deformation: snoring during sleep makes the airway narrow, respiratory resistance increases, so it will forcefully inhale and pull the thorax. At this time, the child is in the stage of growth and development, and the bones are relatively soft, which may easily lead to deformation of the thorax in the long run.

Thoracic abnormality: If the size of the thorax is found during examination, the shape changes obviously, and the normal state is lost. The thoracic symmetry or asymmetrical morphological change is the thoracic abnormality. Because of the different degree of deformation of the various structures of the thoracic structure, various forms are formed. Abnormal chest. Smaller thorax can be considered congenital thoracic deformity, long-term bedridden patients, rickets and hypertrophic adenoid hyperplasia; chest enlargement is mostly barrel chest, seen in chronic bronchitis, bronchial asthma, emphysema and the elderly and Obese body shape; changes in the shape of the thorax can be various, such as flat chest, barrel chest, chicken breast, funnel chest, unilateral or localized deformation of the thorax.

The chicken breast is a sternum with a wedge-shaped convex shape on the chest wall, and the funnel chest is a concave deformity of the chest wall.

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