• A pictorial essay of thoracic wall diseases: multiple pathologies in the same anatomical site

    Giuliana La Rosa, Miriam Adorna, Letizia Antonella Mauro, Monica Pennisi, Andrea Giovanni Musumeci, Alessandra Sigona, Claudia Mattina, Giuseppe Belfiore, Pietro Valerio Foti, Antonio Basile, Stefano Palmucci
    Insights Imaging. 2025 Sep 20;16(1):200. doi: 10.1186/s13244-025-02073-8.

    Abstract

    Objectives: To describe diagnostic and radiological features of the main pathologies affecting the thoracic wall, providing a pictorial atlas based on several clinical cases extracted from our archive. 

     Materials and methods: A wide variety of pathologies affect the tissues of the thoracic cage; these conditions are often encountered by radiologists during examinations performed for unrelated clinical questions. Modern imaging techniques enable the detection of these pathologies and allow definitive diagnoses to be achieved. 

     Results: Pathological processes that involve the chest wall may be classified into: (1) congenital and developmental diseases: pectus excavatum, pectus carinatum, supernumerary rib syndrome, Poland syndrome, neurofibromatosis, osteogenesis imperfecta, mucopolysaccharidosis, Marfan syndrome; (2) infectious and inflammatory diseases-such as aspergillosis, tuberculosis, abscesses from pyogenic bacteria, Tietze's syndrome; (3) bone injuries (traumatic and degenerative diseases): sternal, vertebral and costal fractures, degenerative disc and arthrosis pathology; (4) chest wall tumors-such as sarcomas, lymphomas, neurogenic tumors, lipoma. 

     Conclusions: Thoracic wall pathologies include a wide spectrum of conditions, with some clinical implications that often require a correct nosological framing. Recognizing these pathologies is essential for radiologists so that they can make a correct description in the report and direct toward appropriate treatment if required. 

     Critical relevance statement: Cage diseases are various and difficult to understand, so multimodality imaging plays a crucial role in achieving an efficient and final diagnosis.