Chest Wall Masses

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III.Diseases of the Chest Wall
1- Masses: Sonography is a sensitive, although not at all specific, tool for the detection of masses arising from the chest wall. Its role in the study of such masses is limited to detection of chest wall masses. Other more specific tools, such as MRI and CT must be used to provide a more precise diagnosis ( Vollmer and Gayete2010).
2- Rib fractures: After chest trauma, US may be used in the diagnosis of rib fracture. Sonography is best performed along the line of the rib and over the site of maximum tenderness (Koh et al.,2002). Fracture appears as a gap, step, or displacement of the cortex of the rib (Fig 23). The fracture may be associated with a localized hematoma, effusion, or soft-tissue swelling. Subtle
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Approximately 75% of mediastinal masses (Fig 25) found in the anterior and middle compartments.These spaces are accessible by ultrasound, a fact that allows to study these mediastinal masses and assess vessel infiltration or cystic nature of these lesions (Mathis et al.,2010). The evaluation of mediastinal lymph nodes have better results with ultrasound than with conventional radiology . The overall sensitivity of ultrasound for the study of mediastinal lymph nodes is 62% ( Vollmer and Gayete 2010). 2-Pericardial effusion: Pericardial effusion appears as anechoic stripe surrounding the heart (Fig.26). Smaller effusions will appear as a thin stripe inside the pericardial space, often not extending fully around the heart and usually layering out posteriorly with gravity(Goodman et al.,2012). Occasionally, pericardial effusions may be loculated and compress only a portion of the heart. This is more common with post-cardiac surgery

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