From the Research
Imaging for pectus carinatum should begin with a chest radiograph (X-ray) and may include a non-contrast chest CT scan for more detailed evaluation, with consideration of radiation exposure, especially in pediatric patients 1. The initial assessment of pectus carinatum typically involves a chest radiograph (X-ray) to evaluate the extent of sternal protrusion, including both anteroposterior and lateral views.
- For more detailed evaluation, a non-contrast chest CT scan is recommended as it provides precise measurements of the severity of the deformity, including the Haller index and correction index 2.
- CT imaging allows for comprehensive assessment of the sternum, costal cartilages, and any associated skeletal abnormalities.
- MRI is generally not necessary unless there are concerns about cardiac or pulmonary complications.
- Echocardiography may be considered if there are clinical concerns about cardiac compression or functional impairment.
- For monitoring treatment progress, particularly in patients using bracing therapy, regular chest radiographs at 3-6 month intervals are sufficient, minimizing radiation exposure 3.
- CT scans should be limited to initial assessment and potentially for pre-surgical planning to reduce cumulative radiation exposure, especially in pediatric patients who represent the majority of pectus carinatum cases.
- Ultrasound has emerging applications for monitoring cartilage flexibility during bracing treatment but is not yet standard practice 4. The management of pectus carinatum should prioritize minimizing radiation exposure, especially in pediatric patients, while also considering the need for detailed evaluation and monitoring of treatment progress 5.