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A grandmother brings her 13-year-old grandson for evaluation after noticing that his breastbone seemed collapsed when he took off his shirt last week. The grandson appears embarrassed and mentions that it has been that way for a while. He reports no symptoms and avoids taking off his shirt in front of others. He denies any shortness of breath, chest pain, or lightheadedness during exertion. His past medical history is unremarkable. He is in sixth grade and has recently moved in with his grandmother after his father was transferred for work. His mother died several years ago in a car accident. He states that he does not smoke and has never touched alcohol. Examination shows a teenage boy appearing his stated age. Visual examination of his chest reveals that the lower portion of the sternum is depressed. Auscultation of the lungs and heart is unremarkable. What disorder of the thorax best describes these findings?

Answer :

The findings of a depressed lower portion of the sternum in a 13-year-old boy without respiratory symptoms are indicative of Pectus Excavatum, a congenital deformity of the anterior thoracic wall.

The scenario described where a 13-year-old boy has a depressed lower portion of the sternum with no respiratory symptoms is most indicative of Pectus Excavatum, also known as sunken or funnel chest. This is a structural deformity of the anterior thoracic wall in which the sternum and rib cage are shaped abnormally. This condition is usually congenital and can be purely cosmetic or, in some cases, it may affect cardiac and respiratory function, but that is not apparent in this case. It is not associated with the growth of adenoids or resulting health issues such as difficulty in breathing through the nostrils. Additionally, it is not related to spontaneous pneumothorax, which is the sudden onset of a collapsed lung, typically presenting with severe symptoms such as chest pain and shortness of breath. Neither is it indicative of conditions such as angina pectoris or myocardial infarction (MI) that also present with different symptoms.

The clinical examination of the lungs and heart, which revealed no unusual findings, supports the diagnosis of Pectus Excavatum as opposed to other thoracic disorders. Although the case details provided do not indicate any immediate function impairment, it is recommended to monitor the condition, especially during the patient's growth period.

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Rewritten by : Barada

Answer:

Here, The disorder of the thorax that describes best is : Funnel chest (pectus excavatum)

Explanation:

Because, a funnel chest is caused by a depression in the lower portion of the sternum.