Anterior chest wall non-traumatic diseases: a road map for the radiologist

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Susanna Guerrini
Giulio Bagnacci
Antonio Barile
Ernesto La Paglia
Francesco Gentili
Luca Luzzi
Nicola Giordano
Antonella Fioravanti
Francesca Bellisai
Luca Cantarini
Luca Volterrani
Bruno Frediani
Maria Antonietta Mazzei


anterior chest wall, ultrasound, magnetic resonance imaging, computed tomography, DECT, sternocostoclavicular joint.


The anterior chest wall (AWC) non-traumatic pathologies are largely underestimated, and early detection through imaging is becoming increasingly important. This paper aims to review the major non-traumatic ACW pathologies, with a particular interest in imaging features and differential diagnosis.


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1. Zappia M, Maggialetti N, Natella R, et al. Diagnostic imaging: pitfalls in rheumatology. Radiol Med 2019; 124: 1167-74.
2. Bruno F, Arrigoni F, Palumbo P, et al. New advances in MRI diagnosis of degenerative osteoarthropathy of the peripheral joints. Radiol Med 2019; 124: 1121-27.
3. Salaffi F, Carotti M, Bosello S, et al. Computer-aided quantification of interstitial lung disease from high resolution computed tomography images in systemic sclerosis: correlation with visual reader-based score and physiologic tests. Biomed Res Int 2015; 2015: 834262.
4. Salaffi F, Carotti M, Di Carlo M, Farah S, Gutierrez M. Adherence to Anti-Tumor Necrosis Factor Therapy Administered Subcutaneously and Associated Factors in Patients With Rheumatoid Arthritis. J Clin Rheumatol 2015; 21: 419-25.
5. Vitali C, Carotti M, Salaffi F. Is it the time to adopt salivary gland ultrasonography as an alternative diagnostic tool for the classification of patients with Sjogren’s syndrome? Comment on the article by Cornec et al. Arthritis Rheum 2013; 65: 1950.
6. Rennie WJ, Jans L, Jurik AG, Sudol-Szopinska I, Schueller- Weidekamm C, Eshed I. Anterior Chest Wall in Axial Spondyloarthritis: Imaging, Interpretation, and Differential Diagnosis. Semin Musculoskelet Radiol 2018; 22: 197-206.
7. Edwin J, Ahmed S, Verma S, Tytherleigh-Strong G, Karuppaiah K, Sinha J. Swellings of the sternoclavicular joint: review of traumatic and non-traumatic pathologies. EFORT Open Rev 2018; 3: 471-84.
8. Higginbotham TO, Kuhn JE. Atraumatic disorders of the sternoclavicular joint. J Am Acad Orthop Surg 2005; 13: 138-45.
9. Salaffi F, Carotti M, Barile A. Musculoskeletal imaging of the inflammatory and degenerative joints: current status and perspectives. Radiol Med 2019; 124: 1067-70.
10. Bruno F, Arrigoni F, Mariani S, et al. Advanced magnetic resonance imaging (MRI) of soft tissue tumors: techniques and applications. Radiol Med 2019; 124: 243-52.
11. Scaglione M, Salvolini L, Casciani E, Giovagnoni A, Mazzei MA, Volterrani L. The many faces of aortic dissections: Beware of unusual presentations. Eur J Radiol 2008; 65: 359-64.
12. Agostini A, Kircher MF, Do RK, et al. Magnetic Resonanance Imaging of the Liver (Including Biliary Contrast Agents)-Part 2: Protocols for Liver Magnetic Resonanance Imaging and Characterization of Common Focal Liver Lesions. Semin Roentgenol 2016; 51: 317-33.
13. Agostini A, Kircher MF, Do R, et al. Magnetic Resonance Imaging of the Liver (Including Biliary Contrast Agents) Part 1: Technical Considerations and Contrast Materials. Semin Roentgenol 2016; 51: 308-16.
14. Agliata G, Schicchi N, Agostini A, et al. Radiation exposure related to cardiovascular CT examination: comparison between conventional 64-MDCT and third-generation dualsource MDCT. Radiol Med 2019; 124: 753-61.
15. Agostini A, Mari A, Lanza C, et al. Trends in radiation dose and image quality for pediatric patients with a multidetector CT and a third-generation dual-source dual-energy CT. Radiol Med 2019; 124: 745-52.
16. Russo S, Lo Re G, Galia M, et al. Videofluorography swallow study of patients with systemic sclerosis. Radiol Med 2009; 114: 948-59.
17. Pinto A, Lanza C, Pinto F, et al. Role of plain radiography in the assessment of ingested foreign bodies in the pediatric patients. Semin Ultrasound CT MR 2015; 36: 21-7.
18. Tytherleigh-Strong G, Mulligan A, Babu S, See A, Al-Hadithy N. Digital tomography is an effective investigation for sternoclavicular joint pathology. Eur J Orthop Surg Traumatol 2019; 29: 1217-21.
19. Carotti M, Salaffi F, Di Carlo M, Giovagnoni A. Relationship between magnetic resonance imaging findings, radiological grading, psychological distress and pain in patients with symptomatic knee osteoarthritis. Radiol Med 2017; 122: 934-43.
20. Barile A, Bruno F, Mariani S, et al. What can be seen after rotator cuff repair: a brief review of diagnostic imaging findings. Musculoskelet Surg 2017; 101: 3-14.
21. Dialetto G, Reginelli A, Cerrato M, et al. Endovascular stent-graft treatment of thoracic aortic syndromes: a 7-year experience. Eur J Radiol 2007; 64: 65-72.
22. Ierardi AM, Tsetis D, Ioannou C, et al. Ultra-low profile polymer- filled stent graft for abdominal aortic aneurysm treatment: a two-year follow-up. Radiol Med 2015; 120: 542-8.
23. Cazzato RL, Arrigoni F, Boatta E, et al. Percutaneous management of bone metastases: state of the art, interventional strategies and joint position statement of the Italian College of MSK Radiology (ICoMSKR) and the Italian College of Interventional Radiology (ICIR). Radiol Med 2019; 124: 34- 49.
24. Zoccali C, Rossi B, Zoccali G, et al. A new technique for biopsy of soft tissue neoplasms: a preliminary experience using MRI to evaluate bleeding. Minerva Med 2015; 106: 117-20.
25. Masciocchi C, Arrigoni F, La Marra A, Mariani S, Zugaro L, Barile A. Treatment of focal benign lesions of the bone: MRgFUS and RFA. Br J Radiol 2016; 89: 20150356.
26. Bellelli A, Silvestri E, Barile A, et al. Position paper on magnetic resonance imaging protocols in the musculoskeletal system (excluding the spine) by the Italian College of Musculoskeletal Radiology. Radiol Med 2019; 124: 522-38.
27. Di Cesare E, Cademartiri F, Carbone I, et al. [Clinical indications for the use of cardiac MRI. By the SIRM Study Group on Cardiac Imaging]. Radiol Med 2013; 118: 752- 98.
28. Gentili F, Cantarini L, Fabbroni M, et al. Magnetic resonance imaging of the sacroiliac joints in SpA: with or without intravenous contrast media? A preliminary report. Radiol Med 2019; 124: 1142-50.
29. La Paglia E, Zawaideh JP, Lucii G, Mazzei MA. MRI of the axial skeleton: differentiating non-inflammatory diseases and axial spondyloarthritis: a review of current concepts and applications : Special issue on “musculoskeletal imaging of the inflammatory and degenerative joints: current status and perspectives”. Radiol Med 2019; 124: 1151-66.
30. D’Orazio F, Splendiani A, Gallucci M. 320-Row Detector Dynamic 4D-CTA for the Assessment of Brain and Spinal Cord Vascular Shunting Malformations. A Technical Note. Neuroradiol J 2014; 27: 710-7.
31. Mazzei MA, Contorni F, Gentili F, et al. Incidental and Underreported Pleural Plaques at Chest CT: Do Not Miss Them-Asbestos Exposure Still Exists. Biomed Res Int 2017; 2017: 6797826.
32. Biondi M, Vanzi E, De Otto G, et al. Water/cortical bone decomposition: A new approach in dual energy CT imaging for bone marrow oedema detection. A feasibility study. Phys Med 2016; 32: 1712-16.
33. Mazzei MA, Volterrani L. Errors in multidetector row computed tomography. Radiol Med 2015; 120: 785-94.
34. Carotti M, Salaffi F, Beci G, Giovagnoni A. The application of dual-energy computed tomography in the diagnosis of musculoskeletal disorders: a review of current concepts and applications. Radiol Med 2019; 124: 1175-83.
35. Agostini A, Borgheresi A, Mari A, et al. Dual-energy CT: theoretical principles and clinical applications. Radiol Med 2019; 124: 1281-95.
36. Reginelli A, Capasso R, Petrillo M, et al. Looking for Lepidic Component inside Invasive Adenocarcinomas Appearing as CT Solid Solitary Pulmonary Nodules (SPNs): CT Morpho-Densitometric Features and 18-FDG PET Findings. Biomed Res Int 2019; 2019: 7683648.
37. Li M, Wang B, Zhang Q, et al. Imageological measurement of the sternoclavicular joint and its clinical application. Chin Med J (Engl) 2012; 125: 230-5.
38. Lawrence CR, East B, Rashid A, Tytherleigh-Strong GM. The prevalence of osteoarthritis of the sternoclavicular joint on computed tomography. J Shoulder Elbow Surg 2017; 26: e18-e22.
39. Giacomelli R, Afeltra A, Alunno A, et al. Guidelines for biomarkers in autoimmune rheumatic diseases - evidence based analysis. Autoimmun Rev 2019; 18: 93-106.
40. Mascalchi M, Maddau C, Sali L, et al. Circulating tumor cells and microemboli can differentiate malignant and benign pulmonary lesions. J Cancer 2017; 8: 2223-30.
41. Rodriguez-Henriquez P, Solano C, Pena A, et al. Sternoclavicular joint involvement in rheumatoid arthritis: clinical and ultrasound findings of a neglected joint. Arthritis Care Res (Hoboken) 2013; 65: 1177-82.
42. Filippucci E, Cipolletta E, Mashadi Mirza R, et al. Ultrasound imaging in rheumatoid arthritis. Radiol Med 2019; 124: 1087-100.
43. Marchesoni A, D’Angelo S, Anzidei M, et al. Radiologistrheumatologist multidisciplinary approach in the management of axial spondyloarthritis: a Delphi consensus statement. Clin Exp Rheumatol 2019; 37: 575-84.
44. Conticini E, Di Martino V, De Stefano R, Frediani B, Volterrani L, Mazzei MA. Crowned Dens Syndrome Presenting as Hemiplegia and Hypoesthesia. J Clin Rheumatol 2019;
45. Guglielmi G, Scalzo G, Cascavilla A, Salaffi F, Grassi W. Imaging of the seronegative anterior chest wall (ACW) syndromes. Clin Rheumatol 2008; 27: 815-21.
46. Brzezinska-Wcislo L, Bergler-Czop B, Lis-Swiety A. Sonozaki syndrome: case report and review of literature. Rheumatol Int 2012; 32: 473-7.
47. Hyodoh K, Sugimoto H. Pustulotic arthro-osteitis: defining the radiologic spectrum of the disease. Semin Musculoskelet Radiol 2001; 5: 89-93.
48. Rukavina I. SAPHO syndrome: a review. J Child Orthop 2015; 9: 19-27.
49. Fioravanti A, Cantarini L, Burroni L, Mazzei MA, Volterrani L, Galeazzi M. Efficacy of alendronate in the treatment of the SAPHO syndrome. J Clin Rheumatol 2008; 14: 183-4.
50. Richman KM, Boutin RD, Vaughan LM, Haghighi P, Resnick D. Tophaceous pseudogout of the sternoclavicular joint. AJR Am J Roentgenol 1999; 172: 1587-9.
51. Chhana A, Doyle A, Sevao A, et al. Advanced imaging assessment of gout: comparison of dual-energy CT and MRI with anatomical pathology. Ann Rheum Dis 2018; 77: 629- 30.
52. Cone RO, Resnick D, Goergen TG, Robinson C, Vint V, Haghighi P. Condensing osteitis of the clavicle. AJR Am J Roentgenol 1983; 141: 387-8.
53. Volterrani L, Mazzei MA, Giordano N, Nuti R, Galeazzi M, Fioravanti A. Magnetic resonance imaging in Tietze’s syndrome. Clin Exp Rheumatol 2008; 26: 848-53.
54. Gentili F, Pelini V, Lucii G, et al. Update in diagnostic imaging of the thymus and anterior mediastinal masses. Gland Surg 2019; 8: S188-S207.
55. Levy M, Goldberg I, Fischel RE, Frisch E, Maor P. Friedrich’s disease. Aseptic necrosis of the sternal end of the clavicle. J Bone Joint Surg Br 1981; 63B: 539-41.
56. Mak SM, Bhaludin BN, Naaseri S, Di Chiara F, Jordan S, Padley S. Imaging of congenital chest wall deformities. Br J Radiol 2016; 89: 20150595.

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