Pediatric Nuss Bar Malfunction

  • Etiology: Nuss bar is placed to correct pectus excavatum deformity
  • Imaging CXR:
    — On the immediate post operative exam, look for pneumothorax and check that the Nuss bar stabilizers are in correct position
    — On followup radiographs check that the Nuss bar stabilizers are in correct position
  • DDX:
  • Complications:
    — Pneumothorax after Nuss bar placement
    — Nuss bar stabilizer is loosening
    — Nuss bar stabilizer has fallen off
  • Treatment: Nuss bar replacement
  • Clinical:

Radiology Cases of Nuss Bar Malfunction

Radiology Cases of Normal Appearance of Nuss Bar

CXR of correct position of Nuss bar
CXR AP shows no evidence of pneumothorax. The Nuss bar stabilizers bilaterally are in their correct position in relation to the Nuss bar.

Radiology Cases of Nuss Bar Stabilizer Loosening

CXR of Nuss bar malfunction with Nuss bar stabilizer loosening
Immediate post operative CXR AP (above) shows normal connection and position of the two Nuss bar stabilizers. CXR AP (below) obtained 3 months later shows the right Nuss bar stabilizer is sliding off the Nuss bar.

Radiology Cases of Nuss Bar Stabilizer Separating From Nuss Bar

CXR of Nuss bar stabilizer separation from Nuss bar
CXR AP shows the right Nuss bar stabilizer is normally connected to the Nuss bar but the left Nuss bar stabilizer is no long connected to the Nuss bar.