Also known as funnel chest
Most common congenital deformity of sternum
Sternum is depressed so that ribs protrude anteriorly more than sternum itself
CXR frontal:
Indistinct right heart border
Decreased heart density
Left displacement of heart
Ribs show increase in downward angulation of anterior portions of ribs
Increased density in inferomedial right hemithorax
CXR lateral:
Shows position of sternum
CT:
Needed when surgical correction is considered
Pectus index = transverse diameter of the chest divided by AP diameter, more than 3.25 need surgical correction (normal is 2.31 to 2.91)
CT also useful in quantifying depression, asymmetry, flatness and in assessing the outcome of the procedure
References:
1. Kurihara Y et al. The Ribs: Anatomic and Radiologic Considerations.Radiographics. 1999;19:105-119
2. Jeung MY et al. Imaging of Chest Wall Disorders. Radiographics. 1999;19:617-637
