Pectus Excavatum

  • Etiology: congenital depression of sternum
  • Imaging: Haller index = transverse diameter of chest (inner rib to inner rib) divided by AP diameter of chest (back of sternum to anterior part of vertebral body) where chest is narrowest, lines should be perpendicular to each other, it needs to be > 3.25
  • Clinical: can have chest pain from sternum rubbing against parietal pericardium or shortness of breath, corrected by Nuss bar

Cases of Pectus Excavatum

CXR and CT of pectus excavatum
CXR PA and lateral and axial CT without contrast of the chest shows marked depression of the sternum posteriorly leading to deformation of the chest wall.
CT of pectus excavatum
3D reconstruction from a CT without contrast of the chest (above) and an axial CT from the same exam (below) shows posterior indentation of the sternum towards the spine. The Haller index was calculated to be 5.3.
Clinical image of pectus excavatum
Clinical image shows a marked concavity of the chest wall.