Ultrasound of the axillary arch muscle in children

Steiger, Philipp; Bucher, Oliver; Stranzinger, Enno (2013). Ultrasound of the axillary arch muscle in children. In: Swiss Congress of Radiology 2013. Luzern. 30.05.-01.06.2013.

Purpose: Unilateral or bilateral axillary masses in children are often of
clinical concern for malignancies. Our review illustrates a normal variant
of the axilla mimicking clinically an axillary mass.
Methods and Materials: Systematic review of our PACS and RIS
with the keyword “axilla” and the modality “ultrasound” in children under
16 years of age from 1.12.2009 until 30.11.2012. 19 axillary ultrasound
examinations in 16 patients (7m/9f, age 3 months to 15 years)
were included. One patient was examined 2 and one patient 3 times.
In 6 patients a prominent muscle was noted overlying the humeral head
in an abducted position. The muscle diameter was measured in cm
and compared with the contralateral side. In one patient photographs of
the axilla were available.
Results: In 16 examinations a lymphadenopathy (n=5), abscess formation
(n=5), seroma or hematoma (n=1) or lymphangioma (n=1) and no
diagnosis (n=1) was found. In 4 patients (25%) a unilateral muscle variant
and in 2 patients a bilateral muscle variant (axillary arch muscle) was
noted. In one patient a duplication of the muscle was found. In 4 patients
the muscle was larger than the contralateral side.
Conclusion: An axillary mass in children without other clinical complaints
may be related to a normal variant, the axillary arch muscle. Ultrasound
is the first modality of choice if imaging is required. Radiologists
should be aware of this normal variant since no other workup is necessary
in asymptomatic children.

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