(1,3) Rib & Sternum Anomalies

Question 1

What is an Srb anomaly?

Answer 1

partial or complete fusion of 1st and 2nd rib

Question 2

Does Srb anomaly occur anteriorly or posteriorly?

Answer 2

anterior ribs

Question 3

What is the clinical significance of an Srb anomaly?

Answer 3

concern for TOS as it affects anterior scalene mm

Question 4

What is the diagnosis?

Answer 4

Srb anomaly

Question 5

What is the most common rib anomaly?

Answer 5

Lushka bifurcated rib

Question 6

What is a Lushka bifurcated rib?

Answer 6

forked anterior aspect of rib

Question 7

What is the clinical presentation of a Lushka bifurcated rib?

Answer 7

presents like a fixated rib, but without pain

Question 8

What is the clinical significance of a Lushka bifurcated rib?

Answer 8

no clinical significance

Question 9

What is a rib foramen?

Answer 9

an oval-shaped corticated “foramen” in the posterior lower rib

Question 10

What is the clinical significance of a rib foramen?

Answer 10

no clinical significance

Question 11

Name a differential diagnosis for a rib foramen

Answer 11

benign tumor (ABC or enchondroma)

Question 12

What is an intrathoracic rib?

Answer 12

costal process that arises from the lateral vertebral body or posterior rib

Question 13

Describe the typical location of an intrathoracic rib

Answer 13

• most commonly in midthoracic spine
• descends vertically within thorax in a curvilinear course tapering

Question 14

What is rib synostosis?

Answer 14

early bony bridging/fusion on anterior or posterior, over a long segment of 2 or more ribs

Question 15

Name an associated diagnosis for rib synostosis

Answer 15

block vertebrae or hemivertebrae

Question 16

What is the name for ribs at the L1 vertebra?

Answer 16

gorilla ribs

Question 17

What is the diagnosis?

Answer 17

Lumbar rib

Question 18

What is the diagnosis?

Answer 18

Intrathoracic rib

Question 19

What is the diagnosis?

Answer 19

Rib synostosis

Question 20

What is the diagnosis?

Answer 20

Lushka bifurcated rib

Question 21

What is the diagnosis?

Answer 21

Rib foramen

Question 22

What is the most common deformity of the chest wall?

Answer 22

Pectus Excavatum

Question 23

What is pectus excavatum?

Answer 23

exaggerated anterior concavity of the sternum

Question 24

What are the potential causes of pectus excavatum?

Answer 24

• most cases idiopathic
• fetal alcohol syndrome
• CT disorders (Marfan syndrome, Ehlers Danlos)

Question 25

What is the clinical significance of pectus excavatum?

Answer 25

most are incidental findings - less rib excursion (rigid t/s) = diminished vital capacity - possible cardiopulmonary insufficiency - possible aneurysm formation (^ w/ CT disorders)

Question 26

What radiographic finding of pectus excavatum is seen on an AP view?

Answer 26

cardiac shift (complete L sided heart shadow)

Question 27

What causes cardiopulmonary insufficiency in a patient with pectus excavatum?

Answer 27

compression of right atrium and ventricle

Question 28

If you see a complete left-sided heart shadow on an AP view of the thoracic spine, what are you concerned about?

Answer 28

atelectasis (until you see lat t/s view)

Question 29

What is pectus carinatum?

Answer 29

sternum is bowed anteriorly

Question 30

What is the term used to describe the appearance of pectus excavatum?

Answer 30

"funnel chest"

Question 31

What is the term used to describe the appearance of pectus carinatum?

Answer 31

"pigeon breast chest"

Question 32

What condition is associated with pectus carinatum?

Answer 32

morquio's syndrome

Question 33

What happens to the retrosternal space in a patient with pectus excavatum?

Answer 33

decreased

Question 34

What is the diagnosis?

Answer 34

Pectus excavatum

Question 35

Name a radiographic finding.

Answer 35

Cardiac shift (Dx: Pectus excavatum)

Question 36

What is the diagnosis?

Answer 36

Pectus carinatum

Question 37

What is the diagnosis?

Answer 37

Pectus carinatum

Question 38

What is costochondral cartilage calcification?

Answer 38

Calcification of anterior rib (Normal physiologic phenomenon)

Question 39

What is the diagnosis?

Answer 39

Costochondral cartilage calcification