Chest wall deformities detected in lung radiographs during routine health screening in young healthy male athletes training for police services duty

Yıl 2024, Cilt: 18 Sayı: 1, 11 - 18, 29.04.2024

Kemal Buğra Memiş , Muhsin Özgün Öztürk , Sonay Aydın , Edhem Ünver

Öz

Objectives: Chest wall deformities are a series of abnormalities that extend from the sternum to the vertebral column and often cause aesthetic and psychological problems. Most chest wall deformities are caused by cartilaginous malformations such as pectus excavatum and pectus carinatum. The aim of this study was to provide a detailed description of chest wall abnormalities in young male athletes with no existing complaints.
Methods: A comprehensive health assessment was performed on 1600 young men at the Erzincan Police Vocational Training Centre in March 2023. The evaluation included chest radiographs, pulmonary function tests, electrocardiography, transthoracic echocardiography, haemogram, biochemical test findings and comorbidities. Haller index scale was used to grade the severity of pectus deformity in individuals with pectus excavatum.
Results: Pectus excavatum deformity was detected in 16 individuals (1%). Pectus carinatum was detected in only one individual (0.06%). Only one of the patients with chest wall deformity had an abnormal pulmonary function test, especially in the form of a minor obstructive pattern. In addition, 11 individuals in this group had associated electrocardiographic abnormalities. These abnormalities did not cause significant clinical findings.
Conclusion: Our study showed that the prevalence of chest wall deformities in physically active young men is comparable to the prevalence of chest wall deformities reported for the general population in the available literature. Furthermore, this study demonstrated a higher prevalence of electrocardiographic abnormalities in subjects with chest wall deformities.

Anahtar Kelimeler

chest radiograph, electrocardiography, pectus carinatum, pectus excavatum, respiratory function tests

Kaynakça

• Saxena AK. Classification of chest wall deformities. In: Saxena A, editor. Chest wall deformities. Heidelberg: Springer; 2007. p. 19–35.
• Fokin AA, Steuerwald NM, Ahrens WA, Allen KE. Anatomical, histologic, and genetic characteristics of congenital chest wall deformities. Semin Thorac Cardiovasc Surg 2009;21:44–57.
• Katrancioglu O, Akkas Y, Sahin E, Demir F, Katrancioglu N. Incidence of chest wall deformity in 15,862 students in the province of Sivas, Türkiye. Turk Gogus Kalp Damar Cerrahisi Derg 2023;31:116–22.
• Andrea A, Tardieu G, Fisahn C, Iwanaga J, Oskouian RJ, Tubbs RS. Bifid ribs: a comprehensive review. Anatomy 2016;10:221–7.
• Acastello E. Patologias de la pared toracica en pediatria. Buenos Aires: Zagier & Urruty Pubns; 2012. p. 328.
• Daunt S, Cohen J, Miller S. Age-related normal ranges for the haller ındex in children. Pediatr Radiol 2004;34:326–30.
• Rattan AS, Laor T, Ryckman FC, Brody AS. Pectus excavatum imaging: enough but not too much. Pediatr Radiol 2010;40:168–72.
• Park CH, Kim TH, Haam SJ, Jeon I, Lee S. The etiology of pectus carinatum involves overgrowth of costal cartilage and undergrowth of ribs. J Pediatr Surg 2014;49:1252–8.
• McHam B, Winkler L. Pectus carinatum. [Updated 2023 Jul 31]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; PMID:31082165.
• Desmarais TJ, Keller MS. Pectus carinatum. Curr Opin Pediatr 2013;25:375–81.
• Glorioso J Jr, Reeves M. Marfan syndrome: screening for sudden death in athletes. Curr Sports Med Rep 2002;1:67–74.
• Haller JA Jr, Kramer SS, Lietman SA. Use of CT scans in selection of patients for pectus excavatum surgery: a preliminary report. J Pediatr Surg 1987;22:904–6.
• Höppener PF, Kragten HA, Winkens R. Cardiological aspects of symptomatic pectus excavatum in adults. In: Saxena A, editor. Chest wall deformities. Heidelberg: Springer; 2007. p. 261–78.
• Mueller C, Saint-Vil D, Bouchard S. Chest X-ray as a primary modality for preoperative imaging of pectus excavatum. J Pediatr Surg 2008;43:71–3.
• Robicsek F, Watts LT. Pectus carinatum. Thorac Surg Clin 2010;20:563–74.
• Westphal FL, Lima LC, Lima Neto JC, Chaves AR, Santos Júnior VL, Ferreira BL. Prevalence of pectus carinatum and pectus excavatum in students in the city of Manaus, Brazil. J Bras Pneumol 2009;35:221–6.
• Malek MH, Fonkalsrud EW, Cooper CB. Ventilatory and cardiovascular responses to exercise in patients with pectus excavatum. Chest 2003;124:870–82.
• De Feria AE, Bajaj NS, Polk DM, Desai AS, Blankstein R, Vaduganathan M. Pectus excavatum and right ventricular compression in a young athlete with syncope. Am J Med 2018;131:e451–3.
• Lawson ML, Mellins RB, Paulson JF, Shamberger RC, Oldham K, Azizkhan RG, Hebra AV, Nuss D, Goretsky MJ, Sharp RJ, Holcomb GW 3rd, Shim WK, Megison SM, Moss RL, Fecteau AH, Colombani PM, Moskowitz AB, Hill J, Kelly RE Jr. Increasing severity of pectus excavatum is associated with reduced pulmonary function. J Pediatr 2011;159:256–61.
• Almeida VP, Ferreira AS, Guimarães FS, Papathanasiou J, Lopes AJ. The impact of physical activity level, degree of dyspnoea and pulmonary function on the performance of healthy young adults during exercise. J Bodyw Mov Ther 2019;23:494–501.
• Tokur M, Demioz SM, Sayan M, Tokur N, Arpag H. Chest wall deformities and coincidence of additional anomalies, screening results of the 25,000 Turkish children with the review of the literature. Current Thoracic Surgery 2016;1:21–7.
• Awad SF, Barbosa-Barros R, Belem Lde S, Cavalcante CP, Riera AR, Garcia-Nielba J, Anselm DD, Baranchuk A. Brugada phenocopy in a patient with pectus excavatum: systematic review of the ECG manifestations associated with pectus excavatum. Ann Noninvasive Electrocardiol 2013;18:415–20.