Deformation of the chest in children

Introduction Children's thoracic deformation: snoring during sleep makes the airway narrow, respiratory resistance increases, so it will forcefully inhale and pull the thorax. At this time, the child is in the stage of growth and development, and the bones are relatively soft, which may easily lead to deformation of the thorax in the long run. Infants and young children have a large amount of calcium because of their fast growth rate, and there are fewer outdoor activities, which is prone to calcium deficiency. Calcium deficiency in children can cause rickets. The main manifestations of children's thoracic deformation are: 1 sweating on the head after falling asleep, visible baldness. 2 mental irritability, not interested in the surrounding environment, children are not lively. 3 night terrors, often suddenly wake up at night, crying. 4 teething late, the front door is closed, often not closed after 1 year and a half. 5 forehead is high, forming a square skull. 6 often have beaded ribs.

Cause

1. Congenital tonsil hypertrophy;

2. Caused by respiratory infection;

3. Children with calcium deficiency.

an examination

Related inspection

Chest flat chest chest CT chest examination

The normal thorax is composed of 12 thoracic vertebrae, 12 pairs of ribs, the sternum and the connection between them. The thorax has a certain elasticity and mobility, pinching support, protecting the chest and abdominal organs, and participating in respiratory movements. The normal thorax is approximately conical, the upper part is narrow and the lower part is wide, and the sides are roughly symmetrical; the adult anteroposterior diameter is shorter than the transverse diameter (left and right diameter), the ratio of the anteroposterior diameter to the transverse diameter is about 1:1.5, and the anteroposterior diameter of the children and the elderly is slightly smaller. Or equal to the transverse diameter.

Differential diagnosis

1. Barrel chest:

The anteroposterior diameter of the thorax is increased so that it is almost equal to the transverse diameter, and the thorax is in the shape of a barrel. The slope of the rib is reduced to almost horizontal. The intercostal space is widened and sometimes full. The supraclavicular and inferior fossa are flattened or protruded, the neck is short and shoulder high, the upper abdomen angle is obtuse, and the thoracic kyphosis is convex. Barrel chest is common in chronic obstructive emphysema and bronchial asthma attacks, caused by excessive inflation of the lungs and increased lung volume; it can also be seen in some elderly and short-skinned people.

2. Flat chest:

The thorax is flat and the anteroposterior diameter is often less than half of the transverse diameter. The inclination of the rib is increased, and the lower abdomen angle of the lower edge of the rib is an acute angle. The neck is slender, the clavicle is prominent, and the upper and lower clavicle are concave. Found in the elongated body type, can also be seen in chronic wasting diseases, such as tuberculosis.

3. Rickets chest (chicken breast):

Chest lesions caused by rickets are more common in children. The sternum, especially the lower part of the sternum, is prominently convex, and the ribs on both sides are concave. The anteroposterior diameter of the thorax is enlarged and the transverse diameter is reduced. The upper and lower diameters of the thorax are shorter, and the shape is similar to the chicken breast. Sometimes the ribs and the costal cartilage junction are thickened and bulged in a bead shape, arranged on both sides of the sternum in a beaded shape, called rickets. The anterior chest is attached to the diaphragm, because the ribs are soft. Long-term traction by the diaphragm can be inwardly recessed, while the lower margin is eversion to form a horizontal deep groove, called ribrison's groove.

4. Funnel chest:

The sternum at the lower end of the sternum is invaginated, sometimes invaginated along with the attached costal cartilage and resembles a funnel, called the funnel chest. Seen in the case of rickets, long-term compression of the lower sternum, there are also reasons for unknown.

5. One side of the thoracic or limited deformation:

One side of the thoracic bulging is accompanied by a widening of the intercostal space. If there is limited respiratory movement at the same time, the trachea and the heart are displaced to the healthy side, and a large amount of pleural effusion, pneumothorax, liquid pneumothorax, and massive mass in the chest are found on one side; In patients with severe side respiratory function, the healthy side may be compensated emphysema and bulge. Localized chest wall bulge is seen in cardiac hypertrophy, massive pericardial effusion, aortic aneurysm, intrathoracic or chest wall tumor, chest wall inflammation, and subcutaneous emphysema.

One side or localized thoracic depression is more common in atelectasis, lung atrophy, pulmonary fibrosis; extensive tuberculosis, pleural thickening adhesion, lobectomy and so on. At this time, due to the compensatory emphysema of the contralateral side and bulging, the asymmetry of the thorax on both sides is more obvious.

6. Local thoracic protrusion:

Rib osteochondritis often occurs at the junction of the ribs and costal cartilage, and may have one or more rhomboid painful hard masses, which may last for weeks to months. When the rib fractures, the localized protrusion of the fracture site can be seen. When the examiner squeezes the palms of both hands before and after the chest, there will be severe pain in the fracture site and bone friction sounds can be heard at the same time.

7. Thoracic deformation caused by spinal deformity:

Spinal lordosis occurs mostly in the lumbar spine and has no effect on the shape of the thorax. Spinal kyphosis (humpback) occurs in the thoracic vertebrae, the thoracic vertebrae bulge backwards, the upper and lower diameters of the thorax are shortened, the ribs are close together, and the sternum is pulled inward, which is common in thoracic tuberculosis, the elderly, and osteomalacia. In the case of scoliosis, the lateral shoulder height and rib gap are widened, and the contralateral rib space is narrowed, which is seen in thoracic disease, long-term posture or developmental malformation. All of the above conditions can lead to the displacement of organs in the thoracic cavity, and severe cases can cause respiratory and circulatory dysfunction.

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