On physical examination, the sternoclavicular, manubriosternal, and upper two costosternal
joints on both sides were tender.
Patients with acromegaly are more difficult to examine by means of echocardiography due to a higher BMI and bone remodelling, presenting with costosternal
cartilage hypertrophy, and significant thickening of the ribs, which narrows the intercostal space.
In addition to the involvement of the thoracic vertebrae, normal motion is compromised due to fusion of the joints at the costovertebral, costosternal
, manubriosternal and sternoclavicular levels, and chest expansion is therefore significantly restricted.
Poland's syndrome is a rare congenital anomaly characterized by hypoplasia of the breast and nipple scarcity of subcutaneous tissue absence of the costosternal
portion of the pectoralis major muscle lack of the pectoralis minor and major muscle aplasia or deformity of the costal cartilages or ribs II to IV or III to V alopecia of the axillary and mammary region and unilateral brachysyndactyly.
Sibson fascia is also known as the deep cervical fascia, or suprapleural fascia, and acts like a diaphragm across the thoracic inlet, allowing the lung apex to rise above the first costosternal
It has also been called retrosternal, parasternal, substernal, and sub costosternal
. It is caused by a congenital defect in the fusion of septum transverses of the diaphragm and the costal arches.
The Chapman lymphatic points between the costosternal
junctions bilaterally may also be tender, as well as sternal points and midway over the clavicles.
Osteublastosis can occur in the costovertebral joints, the costochrondal joints, the costosternal
joints and the sternoclavicularjoints.