Right and Left Chest Muscle Asymmetry – Poland Syndrome

Poland syndrome is a rare condition that causes right and left chest muscle asymmetry. In Poland syndrome, muscle development on one side of the body is poor. It mainly affects the pectoral muscles; In addition, the fingers on the same side may have webs.

Poland syndrome, which causes asymmetry in the right and left chest muscles, is seen in approximately one in 20,000 people. Although it is present in the person from birth, it is often not noticed until adolescence. The right chest is affected 2 times more often than the left.

This syndrome entered the literature in 1841, when Sir Alfred Poland, while still a medical student, noticed the absence of the sternocostal part of the pectoral muscle in the chest during his examination on a cadaver.

Poland Syndrome Symptoms

In Poland’s syndrome, the trunk appears asymmetrical. The fact that the chest muscles develop on one side and not on the other leads to an unbalanced appearance. All symptoms of Poland syndrome occur on the same side of the body.

There is a visibly lack of muscle on one side in the chest area or, in medical terms, in the pectoral region. The chest may appear to be sunken in. The nipple may be small or absent on the affected side. Subcutaneous adipose tissue may be thin. Armpit hair may not grow on the affected side. The shoulder may appear small on that side. The scapula may be aligned on one side above the other. The rib cage may be underdeveloped on one side. Fingers on the same side as the affected chest may be shorter. There may be webs between the fingers, they may be stuck together. The distance between the elbow and the hand (forearm) may be short on that side. Breast development in women may be weak on that side.

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Extending the arm on that side, carrying and lifting items may be more difficult than on the intact side.

Since it is mostly noticed during adolescence, it can cause concerns about their appearance and psychological problems in young people.

What Causes Poland Syndrome?

The reason is not known exactly. It is thought to be caused by a developmental disorder that occurs around the sixth week while in the womb during the embryonic period. During this period, the weakening of the blood flow to the chest and ribs of the embryo may cause the emergence of Poland syndrome.

It is not clear whether Poland syndrome is familial or not. It is possible for two people in the same family to have this problem, but it is very rare.

Diagnosis

Although Poland syndrome is present from birth, it may not be noticed until puberty. Delay in diagnosis is related to the severity of complaints. Severe cases are diagnosed in infancy; First, the diagnosis can be made based on the developmental delay in the fingers.

With X-ray films, it can be seen whether the bones are affected or not. The bones of the hand, chest, scapula, and forearm are the most affected. Exactly which muscles are affected can be determined with computed tomography and MRI (MRI) films.

Treatment

Treatment of Poland syndrome is mainly reconstructive (plastic) surgery. Existing chest muscles or muscle tissue taken from elsewhere in the body can be used to compensate for the missing muscle tissue. If there is a misalignment in the rib bones, it can be corrected by surgery. If there are webs or adhesions on the fingers, they can be opened with surgery.

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Surgery may not be recommended as soon as the diagnosis is made. In a child who is still developing, surgery may worsen the asymmetry. Therefore, breast development is expected to be completed. Breast implant surgery can be performed in women.

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