Abstract

Ultrasonography is now widely used in rheumatology to explore pathological changes of peripheral joints. High frequency probes allow a precise study of the different structures of the musculoskeletal systems (tendons, muscles, ligaments) but also the surrounding nerves and vascular structures. Anterior thoracic pain can arise from pathological changes of the muscular, articular or bony part of the chest wall. These diseases are poorly known and frequently underdiagnosed. Few imaging modalities are currently available to explore this region. X-ray, CT scan and MRI have all shortcomings due to the superposition of the intra-thoracic organs (heart, lungs) and to the numerous artefacts induced by the chest movements. Ultrasound has several advantages that can be used to assess thoracic wall diseases. In this review, we will first describe the normal echoanatomy of the anterior thoracic chest wall. We will then discuss the current indications and strengths of this imaging modality in pathological conditions such as spondyloarthropathies, bone metastasis, traumatic or mechanical diseases. In view of the paucity of the literature on this subject, new studies will be needed to further confirm the usefulness of thoracic wall ultrasonography in the management of thoracic pain.

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