Incidental Findings Following Radiography of the Thoracic Spine and Chest in our Orthopaedic Practice

Abstract

The purpose of this editorial is to review the literature on incidental radiographic findings of the thoracic spine and chest detected in the common orthopaedic practice, to present congenital, idiopathic, or acquired incidental abnormalities detected at our service in children, adolescents, and adults, and to consider their potential or apparent clinical significance and differential diagnosis. This work excluded patients with fractures, osteomyelitis or discitis, tumors, and systemic disorders. Congenital radiographic findingsDuring the 6 th week of gestation, two chondrification centers form in each half of the vertebral body (called the centrum), which eventually fuse into a solid block of cartilage. The vertebral arch, the transverse processes, and the spinous process also form from chondrification centers, completing the cartilage anlage of each vertebra. Three primary ossification centers develop within the cartilaginous template of the vertebra: one in the centrum and one for each half of the neural arch. The C3-L5 primary ossification centers appear at nine weeks in utero and ossify by one year of life. The C3-L5 secondary ossification centers at each annular vertebral epiphysis at the upper and lower surfaces of the vertebral body, at the tip of the spinous process, and the tip of each transverse process develop after puberty, and fuse about the middle of the third decade [1][2][3].Congenital anomalies of the thoracic spine may be diagnosed during gestation, soon after birth, and later on incidentally on radiographs performed for an unrelated reason or when they become symptomatic [4,5].