ABSTRACT Objective: To analyze reformatted sagittal sternal tomography images and classify sternal body curvature types, and compare different types of pectus populations with one another and with normal individuals. Methods: In total, 50 controls and 167 pectus patients were selected for chest CT to analyze the median sagittal plane, of whom 89 had pectus carinatum (mean age, 12 ± 10 years) and 78 pectus excavatum (mean age, 14 ± 10 years). Clinical types of pectus were classified as inferior, superior, or lateral pectus carinatum, and localized or broad pectus excavatum. The following types of sternal patterns were defined: gradual vertical curve, gradual posterior curve, gradual anterior curve, proximal third curve, middle third curve, distal third curve, anterior rectilinear, vertical rectilinear, and posterior rectilinear. Statistical analyses were performed to compare the different types of pectus with one another and with the control group. Results: Patients with different thoracic deformities, but with similar sternal curvature patterns, were observed. Some types of sternal curvature were significantly more frequent in certain types of pectus (p < 0,05). The gradual vertical curve and anterior rectilinear types prevailed in controls (p < 0,05). Conclusion: Some sternal curvature patterns were more frequent than the others in certain types of pectus and the controls. Level of Evidence II, Prognostic studies - investigating the effect of a patient characteristic on the outcome of disease.

ABSTRACT Objective: To evaluate the sagittal tomographic reformatting of the sternum using unpublished radiographic parameters (indexes and angles), comparing them between the different types of pectus, and controls. Methods: 44 patients with pectus deformities and controls underwent chest CT for analysis. The types of pectus were classified into: inferior pectus carinatum (IPC), superior (SPC) and lateral (LPC), and broad (BPE) and localized pectus excavatum (LPE). The following tomographic parameters were created and measured: (1) spine-manubrium-sternum index (SMS); (2) column-sternum index (CSI); (3) manubrium-sternal angle (MSA); (4) inferior manubrium angle (IMA); and (5) inferior sternum angle (ISA). Statistical analysis was performed between the pectus and control groups, and between the different types of pectus. Results: There was a significant difference between: a) pectus excavatum and pectus carinatum when analyzing the SMS, CSI, MSA and ISA indexes. b) LPE and control group for SMS and ISA. c) LPC and LPE, and LPC and BPE for SMS; d) BPE and LPC for CSI; e) IPC and LPE, and IPC and BPE for ISA; f) SPC and LPE, and SPC and BPE for IMA. Conclusion: The radiographic indexes and angles created provided differentiation parameters between patients with different types of pectus, and between these and controls. Level of Evidence II, Prognostic Studies.

O diagnóstico precoce da artrite reumatoide é essencial para o manejo adequado da condição. Atualmente, considera-se que a fase inicial da doença constitui uma janela de oportunidade terapêutica para a artrite reumatoide. Embora o diagnóstico seja primordialmente clínico, o desenvolvimento e o aprimoramento de métodos laboratoriais e de imagem têm contribuído para o diagnóstico mais precoce e a determinação da conduta na artrite reumatoide inicial. Neste artigo os autores revisam o papel dos principais métodos de imagem utilizados para a avaliação da artrite reumatoide inicial, notadamente a radiologia convencional, a ultrassonografia e a ressonância magnética.

O diagnóstico precoce da artrite reumatoide é essencial para o manejo adequado da condição. Atualmente, considera-se que a fase inicial da doença constitui uma janela de oportunidade terapêutica para a artrite reumatoide. Embora o diagnóstico seja primordialmente clínico, o desenvolvimento e o aprimoramento de métodos laboratoriais e de imagem têm contribuído para o diagnóstico mais precoce e a determinação da conduta na artrite reumatoide inicial. Neste artigo os autores revisam o papel dos principais métodos de imagem utilizados para a avaliação da artrite reumatoide inicial, notadamente a radiologia convencional, a ultrassonografia e a ressonância magnética.