대한흉부영상의학회 Korean Society of Thoracic Radiology

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대한흉부영상의학회 Weekly Case 검색
대한흉부영상의학회 Weekly Case 검색
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Weekly Chest CasesArchive of Old Cases

Case No : 358 Date 2004-09-04

  • Courtesy of Young-Jin Kim, M.D., Byoung Wook Choi, M.D., Kyu Ok Choe, M.D. / Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
  • Age/Sex 19 / F
  • Chief ComplaintIncidentally found abnormality on chest radiograph
  • Figure 1
  • Figure 2

Diagnosis With Brief Discussion

Diagnosis
Straight back syndrome
Radiologic Findings
On chest PA radiograph, the descending thoracic aorta line is obliterated at retrocardiac portion. This finding suggests posterior mediastinal mass or consolidation at the left lower lobe, however, lateral chest radiograph does not demonstrate any consolidation or mass shadow. The lateral chest radiograph revealed a straight thoracic spine with absence of physiological kyphosis. On chest CT, the antero-posterior diameters of thorax and left atrium are short. The reason why the descending thoracic aorta line is obliterated on chest PA radiograph is that left inferior pulmonary vein, left atrium, and ventricle abut the aorta due to compression of the heart.
Brief Review
Straight back syndrome results from the shortening of the distance between the sternum and thoracic spine leading to a compression of the heart. The syndrome is caused by the lack of spine kyphosis. Straight back syndrome sometimes produces clinical symptoms suggesting acquired heart abnormalities. However, hemodynamic cardiac functioning is normal. Whereas several authors reported in the sixties that there have been significant organic heart defects (such as mitral valve prolapse), reports in nineties demonstrated this syndrome bore no associations with structural heart diseases
References
1. Tokushima T, Utsunomiya T, Ogawa T, et al. Contrast-enhanced radiographic computed tomographic findings in patients with straight back syndrome. Am J Card Imaging 1996;10(4):228-34.

2. Spapen HD, Reynaert H, Debeuckelaere S, Segers O, Somers G. The straight back syndrome. Neth J Med 1990;36(1-2): 29-31.

3. Arthur JT. Straight-back syndrome. A case report and review of the literature. West Afr J Med 1995;14(1):61-4.
Keywords
Vertebra, Congenital,

No. of Applicants : 30

▶ Correct Answer : 9/30,  30.0%
  • - Annecy Hospital, France Gilles Genin
  • - Boeun hanyang hospital, Korea Cheolkyu Jung
  • - Dong-A University Hospital, Korea Ki-Nam Lee
  • - Hangang SacredHeart Hospital, Korea Eil Seong Lee
  • - Hanyang University Hospital, Seoul, Korea Yo Won Choi
  • - National Taiwan University Hospital, Taiwan Tan Che Kim
  • - Ondokuz Mayis University, Samsun, Turkey Cetin Celenk
  • - Pusan National University Hospital, Busan Hyun Wook Choi
  • - Sharma Clinic, Jaipur, India Dinesh Sharma
▶ Semi-Correct Answer : 9/30,  30.0%
  • - Asan Medical Center, Korea Eun Jin Chae
  • - Centre d'imagerie Jacques Callot, Nancy, France Lionel Cannard
  • - Chonnam National University Hospital, Korea Yong-Ju Moon
  • - CHU Nancy-Brabois, France Denis Regent
  • - CIM Saint Dizier, France JC Leclerc
  • - Korea Univ Ansan Hopspital, Korea Je Bo-Kyung
  • - Incheon Sarang Hospital, Korea Jung Hee Kim
  • - Social Security Hospital, Ankara, Turkey Meric Tuzun
  • - University Hospital of North Staffordshire, UK Voon Ping Liaw
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