title: Chest wall deformity found in patients with primary spontaneous pneumothorax.
abstract: BACKGROUND
  the current consensus is that primary spontaneous pneumothorax frequently occurs in young male patients who are tall and thin. However, upon careful observation, many chest wall deformities have been recognized in primary spontaneous pneumothorax patients. We investigated the distinctive features of the chest wall configuration of primary spontaneous pneumothorax patients by comparing them with controls (normal and Marfan syndrome patients).
  
  
  METHODS
  the anteroposterior and transverse diameters of the bilateral hemithoraxes of each patient at predetermined levels were measured by computed tomography. The asymmetry, which was based on the right/left anteroposterior and right/left transverse diameter ratio, and thickness based on the anteroposterior/transverse ratio, were examined.
  
  
  RESULTS
  severe anteroposterior asymmetry and transverse asymmetry were observed in Marfan syndrome patients, and moderate anteroposterior asymmetry and transverse asymmetry were observed in primary spontaneous pneumothorax patients in comparison with normal control patients. Primary spontaneous pneumothorax and Marfan patients showed flatter thoraxes than normal control patients.
  
  
  CONCLUSIONS
  primary spontaneous pneumothorax patients tend to have asymmetric and flat thoraxes. Subclinical thoracic wall deformity observed in the primary spontaneous pneumothorax group may partly contribute to alveolar pressure heterogeneity, and may be related to subpleural bleb formation.
authors.affiliation: Department of Thoracic Surgery, Graduate School of Medicine, University of Tokyo, Tokyo, Japan.
authors.forename: Kosuke
authors.initials: K
authors.lastname: Saita
authors.forename: Tomohiro
authors.initials: T
authors.lastname: Murakawa
authors.forename: Hirotaka
authors.initials: H
authors.lastname: Kawano
authors.forename: Atsushi
authors.initials: A
authors.lastname: Sano
authors.forename: Kazuhiro
authors.initials: K
authors.lastname: Nagayama
authors.forename: Jun
authors.initials: J
authors.lastname: Nakajima
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D005260:Female; D020022:Genetic Predisposition to Disease; D006801:Humans; D008297:Male; D008875:Middle Aged; D009139:Musculoskeletal Abnormalities / Q000150:complications* / Q000175:diagnosis / Q000235:genetics; D010641:Phenotype; D011030:Pneumothorax / Q000175:diagnosis / Q000209:etiology* / Q000235:genetics; D012189:Retrospective Studies; D012307:Risk Factors; D035441:Thoracic Wall / Q000002:abnormalities* / Q000000981:diagnostic imaging; D014057:Tomography, X-Ray Computed; D055815:Young Adult
keywords: Genetic predisposition to disease; X-ray computed; lung; pneumothorax; thoracic wall; tomography