[̧̫] sonography of metastic mass at rib
ÀÛ¼ºÀÚ : °ü¸®ÀÚ(khu3265442@naver.com) ÀÛ¼ºÀÏ : 2017-06-29 Á¶È¸¼ö : 3670
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male/56yrs


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pain at left flank(1week)


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flank pain after heavy golf practice , pain with deep inspiration or trunk rotation


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local tenderness left 7th. rib


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lin longitudinal scan of 7th. rib, appearance of bony mass(protrusion) just like callus(image 1).


on moving of prove a little, there is bony protrusion(osteoblastic lesion) and hypoechoic(osteolytic)  lesion(image 2, 3, 4).


in transverse scan, visualization of osteoblastic mass with central osteolytic lesion(image 5, 6).


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CT ; metastacic mass at rib and adjacent lung


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operation



 


Ultrasonography is very useful for diagnosis of minor or linear fracture of rib.
In minor fracture of rib, doctor can see several phase of findings of rib fracture.
In early phase, doctor can only see  soft tissue swelling(case 1) of minor step of of rib cortex(case 2).
Usually  callus formation  take place 2 weeks after of injury, then   doctor can see bony mass(callus) .
If there is no trauma history  or visualization of callus so ealry , doctor consider the possibility of tumors of rib.
As like this case, visualization of osteoblastic lesion and osteolytic lesion in simultaneously  suggests a malignant mass.
     

referance
1. imagingTumors of the rib

https://www.sciencedirect.com/science/article/pii/S2211568413001952


2. High-resolution sonography of the rib: can fracture and metastasis be differentiated?

https://www.ajronline.org/doi/pdf/10.2214/ajr.184.3.01840969


CT image


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1893637843_1a28f778_CT162941145.jpg

1893637843_a950dd50_CT162942146.jpg

1893637843_088e702a_CT162942147.jpg

1893637843_7e09718c_CT162943151.jpg

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