Optimal Imaging Techniques for Detecting Chest Wall Scarring
**Patient Profile** - **Age/Gender:** 25 years old, Male - **Height/Weight:** 5 feet 8 inches, approximately 120 pounds - **Current Medications:** Gabapentin at 300mg three times a day (maximum dosage), previously used Mobic and various other NSAIDs without noticeable improvement - **Smoking/Alcohol Use:** No smoking, no alcohol consumption - **Medical Background:** History of abdominal surgery which resulted in significant adhesions, chronic pain, persistent tightness in the chest, and decline in functionality - **Duration of Symptoms:** Symptoms have been progressively worsening over the last year - **Affected Area:** Entire chest wall **Message to Medical Professionals:** Hello, I am currently experiencing what I believe to be substantial scarring and adhesions in my chest wall. My ribcage has limited expansion capability, and I am plagued by continuous and intense pain, leading me to feel as though the scarring is suffocating the organs within my chest and upper abdominal region. While prior CT scans have revealed atelectasis, scarring, and some fluid accumulation, they do not seem to adequately depict the underlying issues. My entire thoracic cavity is impacted, and my organs seem to struggle under these conditions. Through my research, I've discovered that using chest MRI with STIR (short tau inversion recovery) sequences may prove to be the most effective method for pinpointing scarring and adhesions. I've also come across references to STAR imaging. Prior to advocating for further diagnostic tests with my healthcare providers, I want to ensure I’m seeking the most appropriate approach. In your opinion, what imaging modality is the most sensitive for detecting widespread scarring or adhesions in the chest wall that could be impairing my breathing and compressing internal structures? Is pursuing an MRI with STIR the way to go, or might there be alternative imaging techniques that better serve this purpose? This issue originated following my surgery to address abdominal adhesions, during which the surgeon made an extra incision in my ribcage, despite having had three previous abdominal procedures. Thank you for your assistance in this matter.
Answers (1)
9/6/2025, 1:50:39 AM
OpenHealth AI
To address your concerns about detecting chest wall scarring and adhesions effectively, it's important to use imaging techniques that can provide a clear view of the thoracic cavity and associated structures. Here’s a structured response to your inquiry.
Main Points:
- Chest MRI with STIR sequences is a strong contender for visualizing soft tissue, including scarring and adhesions.
- A CT scan can also play a significant role in assessing structural changes in the chest.
- Discussing these imaging options with your healthcare provider is crucial for tailored care.
Explanation:
Given your history of significant abdominal surgery and current symptoms of chest tightness and pain, the presence of adhesions or scarring could indeed be contributing factors.
- MRI with STIR sequences: This technique is specifically useful for highlighting edema and soft tissue changes, making it valuable for assessing scarring and inflammation. STIR sequences can enhance the contrast between different tissues, allowing for better visualization of abnormalities.
- CT scans: While you’ve had previous CT scans, they are effective in providing detailed images of the chest structure. They might show physical changes like atelectasis and fluid accumulation but may not fully capture subtle soft tissue changes as well as an MRI can.
Next Steps:
-
Consider Advocating for MRI: Discuss with your healthcare provider the option of performing an MRI with STIR sequences. Explain your symptoms clearly and express how you believe this may reveal underlying issues not visible on previous scans.
-
Follow-Up Imaging: If not already discussed, inquire about a comprehensive chest CT scan if necessary. This could complement MRI findings, providing a dual perspective on both soft tissues and structural concerns.
-
Symptom Monitoring: Keep a symptom diary that documents your pain levels, tightness, and any changes over time. This can provide valuable information to your healthcare provider and help tailor your care plan.
-
Seek Multidisciplinary Input: Since your condition involves both chronic pain and potential complications from adhesions, consider getting opinions from specialists such as a pain management physician, thoracic surgeon, or physical therapist specializing in chronic pain.
By focusing on these actions, you can facilitate a thorough evaluation of your condition and ensure that you receive the appropriate imaging and subsequent care. Your concerns are valid, and addressing them systematically will help you find the relief you need. Let me know if you have any more questions or need further details on managing your situation.
Related Questions
Advice Needed After Chalazion Removal
Greetings! I’m a 39-year-old female who has been dealing with a persistent issue involving a sty on my upper left eyelid for the past month. This situation has evolved into a chalazion. My experience included several steps: - Initially dealing with preseptal cellulitis affecting my upper eyelid, - Completing a prescribed course of doxycycline, - Utilizing Neomycin combined with Polymyxin and Dexamethasone eye drops to reduce the chalazion after the infection subsided, - Encountering a possible allergic reaction to the Neomycin drops, which led to switching to another treatment, - An unnecessary follow-up with an optometrist when I should have seen an ophthalmologist, - Starting to use Prednisolone Acetate steroid drops to alleviate itching linked to the allergic reaction, - Finally securing a last-minute appointment with an ophthalmologist yesterday, where they performed a surgical excision of the chalazion. I was using the Prednisolone drops to manage the itchiness caused by the allergic reaction to Neomycin. They seemed effective in easing the discomfort, but my last dose was given just before the chalazion removal. After the surgery, I inquired with the nurse regarding the continuation of these steroid drops. She indicated I could discontinue them. Unfortunately, I didn't frame my question properly and failed to clarify my real intention, which was to ask whether I could keep using them after the procedure. It seems they might have misunderstood my inquiry as a request to stop using the drops altogether. I’m now left wondering if it’s permissible to use the Prednisolone steroid drops after my chalazion has been excised. The only other medication prescribed to me was Erythromycin ophthalmic ointment. I have a feeling that using the steroid drops might still be okay, and I’m inclined to apply them unless I receive advice to the contrary. Any insights would be appreciated!
Persistent Calf Cramps for Half a Year
I am a 22-year-old female standing at 5 feet 6 inches tall and weighing 135 pounds. For the past six months, I have been experiencing nearly unending cramps in my left calf. These episodes tend to worsen primarily at night, but I find them increasingly bothersome throughout the day, especially after I sit or lie down. Interestingly, walking seems to alleviate the discomfort somewhat. I do not smoke, seldom drink alcohol, and I do not take any significant medications apart from birth control pills. After undergoing blood tests, I can confirm that my iron levels are normal. Additionally, I have had scans on both my veins and arteries, and nothing abnormal was found. I would greatly appreciate any assistance with this issue, as it has become quite tiresome and is adversely affecting my sleep and daily activities!
Concerns About Abdominal Distension and Uterine Status
A 65-year-old woman, measuring 5 feet 1 inch and weighing 106 pounds, presents with notable abdominal distension resembling that of a 28-week pregnancy. This condition arose following her bowel resection in January 2022 and the reversal of her ileostomy in April of the same year, both necessitated by a ruptured abscess linked to diverticulitis. Since January, she has experienced discomfort in the right lower quadrant, specifically at her stoma scar site. Despite undergoing a CT scan and pelvic ultrasound in January, which yielded normal results, and extensive evaluations by her gastroenterologist, the only notable finding has been mild swelling in some colonoscopy biopsies. However, her pain has intensified and is now radiating, alongside a notable change in her bowel habits to the consistency of small animal droppings rather than hard stools. Additionally, she reports significant bloating. In early August, a repeat CT scan with both oral and IV contrast revealed heavy stool accumulation and gross distension in the left abdominal area, leading the radiologist to suggest the presence of gastroparesis. Yet, the most alarming finding from this examination indicated that her uterus was described as "surgically absent." Although she acknowledges that the uterus reduces in size post-menopause, she recalls it being present during her prior January imaging, which included measurement of the endometrial lining. Furthermore, the second CT report mentioned it in comparison to a scan from early 2025. The patient conveyed to her gastroenterology nurse practitioner (NP) that the uterus had not been surgically removed in the seven months prior. Recently, the NP communicated that the same radiologist reaffirmed his initial interpretation of the CT, declaring it surgically absent. The NP suggested that the uterus may have collapsed. Given her escalating pain, she is concerned that potential adhesions might be causing discomfort by attaching her uterus to her bowel. Is this a plausible scenario? A transvaginal ultrasound is expected to help clarify the situation, but weeks have passed without any updates. She understands that the uterus may not be visible anymore and would prefer the documentation reflect "unable to visualize uterus" instead of a surgical removal that she never underwent. She is perplexed by the radiologist’s insistence on surgical removal despite no documented history of such a procedure. For context, she has never experienced gastrointestinal issues or constipation prior to her diverticulitis diagnosis, which seemed to strike suddenly. Post-ileostomy reversal, she had no significant issues until the onset of her current right lower quadrant pain, which disrupts her daily life. Notably, she is pain-free during the mornings, with discomfort beginning in the afternoon, intensifying throughout the evening, and subsiding by late night. Despite varying degrees of pain intensity on different days, she has attempted elimination diets and other strategies, but nothing alleviates her symptoms. Loud bowel sounds are also present intermittently. Moreover, she struggles to receive timely responses through her patient portal and is contemplating the use of laxatives to alleviate the stool obstruction, concerned about the risk of dependence. Considering the ongoing challenges she faces, she seeks any advice or insights into her condition.
Unusual Rash on Lower Abdomen
Essential Information: I’m a 22-year-old assigned female at birth, standing at 5 feet 2 inches tall. My precise weight is uncertain, but I do classify as overweight, and the rash I’m experiencing is primarily located on my lower abdomen. Currently, I’m on Slynd for birth control, Trintellix for mental health support, and Xyzal to manage allergies. I have a significant history of eczema, which has been severe at times but is currently managed, as well as allergies that frequently result in skin irritations. Additionally, I suffer from Hidradenitis suppurativa, visible in past images, yet it is not actively being treated at this time. Although I am somewhat accustomed to rashes, this particular one is unfamiliar to me. I began experiencing symptoms of COVID-19 on Sunday, and by Monday night, I noticed this rash developing. It has been intermittently painful over the past few days and is worsening, even though most of my COVID-related symptoms have mostly subsided apart from slight fatigue, head fog, and mild nasal congestion. Tonight, it became increasingly painful, marking the first time I saw it in a couple of days, and it appears to have deteriorated, though I unfortunately did not keep a photo of it for reference. Since the onset of the rash, I’ve showered nightly, except for Thursday, and have been applying Triamcinolone Acetonide Cream USP, which I typically use for eczema flare-ups, alongside Eucerin Original Healing Cream designed for very dry and compromised skin. Could anyone provide guidance on this issue? I intend to schedule an appointment with my primary healthcare provider at the beginning of next week, although their office is currently closed. I do not have a dermatologist at the moment. Should I consider visiting urgent care for this situation? Currently, it feels okay, but the pain fluctuates, and it has been particularly uncomfortable during showers and when touched.
Is Leg Shaking in My 4-Year-Old a Cause for Concern?
A 4-year-old girl, Caucasian and weighing 45 pounds, is under no medication and has no significant health concerns at present. I apologize for the poor quality of the video; the positioning was awkward as she was lying in my lap. Every night, she engages in this leg shaking for approximately half an hour before she falls asleep. Initially, I thought it was a charming and comforting behavior, but it now appears to have escalated in intensity. Could this be indicative of restless leg syndrome, and how could I determine if that is the case? In essence, should I be worried about this behavior?