IMPORTANT: We currently have a number of bugs related to image cropping and are actively trying to resolve them. In the meantime, we have disabled cropping. Apologies for any inconvenience. Stay informed: radiopaedia.org/chat

Pectus excavatum

Case contributed by Henry Knipe
Diagnosis certain

Presentation

Abdominal pain ?perforated viscus.

Patient Data

Age: 50 years
Gender: Female
x-ray

Increased opacity in the medial right lower zone. Loss of right heart border and mild leftward mediastinal shift. 

x-ray

Lateral projection demonstrates pectus excavatum, which accounts for frontal chest x-ray appearances. 

Case Discussion

Pectus excavatum is a common, congenital deformity of the anterior chest wall. It results in easily recognisable chest x-ray findings:

  • blurring of right heart border
  • increased density of the inferomedial lung zone
  • horizontal posterior ribs
  • vertical anterior ribs (heart shaped)
  • displacement of heart towards the left
  • obliteration of the descending aortic interface

Differential diagnosis includes:

  • right middle lobe consolidation/atelectasis
  • left para-aortic soft tissue density (e.g. mass)
  • mediastinal mass due to deformation of the cardiomediastinal contour

How to use cases

You can use Radiopaedia cases in a variety of ways to help you learn and teach.

Creating your own cases is easy.

Updating… Please wait.

 Unable to process the form. Check for errors and try again.

 Thank you for updating your details.