Overview
Chest wall deformities may be an external sign of an underlying disease, or may themselves cause significant restrictive pulmonary disease.
Barrel Chest
Look For
- A rounded, bulging chest.
Causes of Barrel Chest
- Physiological
- Hyperinflation - acute asthma, late emphysema
- Osteoarthritis
Pectus Excavatum
Also known as funnel chest.
Look For
- Inward depression of the sternum.
Causes of Pectus Excavatum
- Marfan syndrome
- Congenital heart diseases
Pectus Carinatum
Also known as pigeon chest.
Look For
- Forward angulation of the sternum
Causes of Pectus Carinatum
- Marfan syndrome
- Down syndrome
Scoliosis
How to Elicit
- Inspect the spine, and then palpate the spinous processes of the vertebrae.
Look For
- Lateral curvature of the spine
- Distortion of the trunk
- Prominence of the ribs
- Asymmetry of skin folds around the flank
- Shoulder elevation
- Scapular rotation
Causes of Scoliosis
- Idiopathic (80%)
- Congenital - maldevelopment of vertebrae
- Neuromuscular disorders - cerebral palsy, muscular dystrophy
- Syndromal - Marfan, neurofibromatosis, Down syndrome
- Trauma - fracture, dislocation, burns
- Degenerative - secondary to facet joint osteoarthritis
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