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Tsujioka Y, Handa A, Nishimura G, Nozaki T, Miyazaki O, Kono T, Bixby SD, Jinzaki M. Pediatric Ribs at Chest Radiography: Normal Variants and Abnormalities. Radiographics 2023; 43:e230076. [PMID: 37943700 DOI: 10.1148/rg.230076] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2023]
Abstract
Normal variants and abnormalities of the ribs are frequently encountered on chest radiographs. Accurate identification of normal variants is crucial to avoid unnecessary investigations. A meticulous evaluation of rib abnormalities can provide valuable insights into the patient's symptoms, and even when no osseous condition is suspected, rib abnormalities may offer critical clues to underlying conditions. Rib abnormalities are associated with various conditions, including benign tumors, malignant tumors, infectious and inflammatory conditions, vascular abnormalities, metabolic disorders, nonaccidental injuries, malformation syndromes, and bone dysplasias. Abnormalities of the ribs are classified into three groups based on their radiographic patterns: focal, multifocal, and diffuse changes. Focal lesions are further subdivided into nonaggressive lesions, aggressive lesions, and infectious and inflammatory disorders. Radiologists should be aware of individual disorders of the pediatric ribs, including their imaging findings, relevant clinical information, and underlying pathogenesis. Differential diagnoses are addressed as appropriate. Since chest radiographs can suffice for diagnosis in certain cases, the authors emphasize a pattern recognition approach to radiographic interpretation. However, additional cross-sectional imaging may be necessary for focal lesions such as tumors or inflammatory conditions. Awareness of disease-specific imaging findings helps ascertain the nature of the lesion and directs appropriate management. ©RSNA, 2023 Quiz questions for this article are available in the supplemental material.
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Affiliation(s)
- Yuko Tsujioka
- From the Department of Radiology, Keio University School of Medicine, Tokyo, Japan (Y.T., T.N., M.J.); Department of Radiology, Tokyo Metropolitan Children's Medical Center, Tokyo, Japan (Y.T., T.K.); Department of Radiology, Boston Children's Hospital and Harvard Medical School, 300 Longwood Ave, Boston, MA 02115 (A.H., S.D.B.); Department of Radiology, Musashino-Yowakai Hospital, Tokyo, Japan (G.N.); and Department of Radiology, National Center for Child Health and Development, Tokyo, Japan (O.M.)
| | - Atsuhiko Handa
- From the Department of Radiology, Keio University School of Medicine, Tokyo, Japan (Y.T., T.N., M.J.); Department of Radiology, Tokyo Metropolitan Children's Medical Center, Tokyo, Japan (Y.T., T.K.); Department of Radiology, Boston Children's Hospital and Harvard Medical School, 300 Longwood Ave, Boston, MA 02115 (A.H., S.D.B.); Department of Radiology, Musashino-Yowakai Hospital, Tokyo, Japan (G.N.); and Department of Radiology, National Center for Child Health and Development, Tokyo, Japan (O.M.)
| | - Gen Nishimura
- From the Department of Radiology, Keio University School of Medicine, Tokyo, Japan (Y.T., T.N., M.J.); Department of Radiology, Tokyo Metropolitan Children's Medical Center, Tokyo, Japan (Y.T., T.K.); Department of Radiology, Boston Children's Hospital and Harvard Medical School, 300 Longwood Ave, Boston, MA 02115 (A.H., S.D.B.); Department of Radiology, Musashino-Yowakai Hospital, Tokyo, Japan (G.N.); and Department of Radiology, National Center for Child Health and Development, Tokyo, Japan (O.M.)
| | - Taiki Nozaki
- From the Department of Radiology, Keio University School of Medicine, Tokyo, Japan (Y.T., T.N., M.J.); Department of Radiology, Tokyo Metropolitan Children's Medical Center, Tokyo, Japan (Y.T., T.K.); Department of Radiology, Boston Children's Hospital and Harvard Medical School, 300 Longwood Ave, Boston, MA 02115 (A.H., S.D.B.); Department of Radiology, Musashino-Yowakai Hospital, Tokyo, Japan (G.N.); and Department of Radiology, National Center for Child Health and Development, Tokyo, Japan (O.M.)
| | - Osamu Miyazaki
- From the Department of Radiology, Keio University School of Medicine, Tokyo, Japan (Y.T., T.N., M.J.); Department of Radiology, Tokyo Metropolitan Children's Medical Center, Tokyo, Japan (Y.T., T.K.); Department of Radiology, Boston Children's Hospital and Harvard Medical School, 300 Longwood Ave, Boston, MA 02115 (A.H., S.D.B.); Department of Radiology, Musashino-Yowakai Hospital, Tokyo, Japan (G.N.); and Department of Radiology, National Center for Child Health and Development, Tokyo, Japan (O.M.)
| | - Tatsuo Kono
- From the Department of Radiology, Keio University School of Medicine, Tokyo, Japan (Y.T., T.N., M.J.); Department of Radiology, Tokyo Metropolitan Children's Medical Center, Tokyo, Japan (Y.T., T.K.); Department of Radiology, Boston Children's Hospital and Harvard Medical School, 300 Longwood Ave, Boston, MA 02115 (A.H., S.D.B.); Department of Radiology, Musashino-Yowakai Hospital, Tokyo, Japan (G.N.); and Department of Radiology, National Center for Child Health and Development, Tokyo, Japan (O.M.)
| | - Sarah D Bixby
- From the Department of Radiology, Keio University School of Medicine, Tokyo, Japan (Y.T., T.N., M.J.); Department of Radiology, Tokyo Metropolitan Children's Medical Center, Tokyo, Japan (Y.T., T.K.); Department of Radiology, Boston Children's Hospital and Harvard Medical School, 300 Longwood Ave, Boston, MA 02115 (A.H., S.D.B.); Department of Radiology, Musashino-Yowakai Hospital, Tokyo, Japan (G.N.); and Department of Radiology, National Center for Child Health and Development, Tokyo, Japan (O.M.)
| | - Masahiro Jinzaki
- From the Department of Radiology, Keio University School of Medicine, Tokyo, Japan (Y.T., T.N., M.J.); Department of Radiology, Tokyo Metropolitan Children's Medical Center, Tokyo, Japan (Y.T., T.K.); Department of Radiology, Boston Children's Hospital and Harvard Medical School, 300 Longwood Ave, Boston, MA 02115 (A.H., S.D.B.); Department of Radiology, Musashino-Yowakai Hospital, Tokyo, Japan (G.N.); and Department of Radiology, National Center for Child Health and Development, Tokyo, Japan (O.M.)
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Greci V, Mortellaro CM, Olivero D, Cocci A, Hawkins EC. Inflammatory polyps of the nasal turbinates of cats: an argument for designation as feline mesenchymal nasal hamartoma. J Feline Med Surg 2011; 13:213-9. [PMID: 21349753 PMCID: PMC10832823 DOI: 10.1016/j.jfms.2010.07.009] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2010] [Revised: 07/10/2010] [Accepted: 07/15/2010] [Indexed: 10/18/2022]
Abstract
Inflammatory polyps of the nasal turbinates (IPNT) in cats are benign growths that are histologically distinct from feline nasopharyngeal polyps. Most cats with IPNT are presented at less than 1 year of age with sneezing, noisy breathing and epistaxis, but without mucoid or mucopurulent nasal discharge. Histologically, IPNT are characterised by the presence of woven bone as part of the proliferating stroma and erythrocyte-filled spaces. These unique histological features are analogous to nasal hamartomas (NH) of children, specifically chondromesenchymal hamartoma (NCMH) and sinonasal fibro-osseous hamartoma (SFOH), which also result in signs of nasal obstruction, sneezing and epistaxis. In our study, clinical and histopathological features in five cats with IPNT were compared with published descriptions of NH in children. We conclude that the terminology 'feline mesenchymal nasal hamartoma' provides a more accurate description of the disease currently termed IPNT, and has the added advantage of being consistent with its human counterpart.
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Affiliation(s)
- Valentina Greci
- Dipartimento di Scienze Cliniche, Facoltà di Medicina Veterinaria, Università degli Studi di Milano, Italy
| | - Carlo M. Mortellaro
- Dipartimento di Scienze Cliniche, Facoltà di Medicina Veterinaria, Università degli Studi di Milano, Italy
| | | | - Andrea Cocci
- Dipartimento di Scienze Cliniche, Facoltà di Medicina Veterinaria, Università degli Studi di Milano, Italy
| | - Eleanor C. Hawkins
- Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, NC 27606, USA
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