Journal Information
Vol. 99. Issue 5.
Pages 366-367 (1 November 2023)
Vol. 99. Issue 5.
Pages 366-367 (1 November 2023)
Images in Paediatrics
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A rare chest wall deformity: Intrathoracic rib
Una malformación inusual de la caja torácica: costilla intratorácica
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Furkan Ufuk
Department of Radiology, Pamukkale University, Denizli, Türkiye
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A girl aged 5 years presented with a cough and difficulty breathing of one week’s duration. She had no known disease, and the physical examination was unremarkable. The posterior-anterior chest radiograph showed an abnormally oriented rib in the upper right side of the chest (Fig. 1). The patient underwent a low-dose CT scan of the chest without contrast for further evaluation. The CT scan revealed the presence of a bifid intrathoracic rib protruding into the lung parenchyma (Fig. 2, Movie). Since the patient’s symptoms were mild, conservative treatment was initiated and a follow-up visit scheduled.

Figure 1.

Anterior–posterior chest radiograph showing an abnormally oriented rib in the right side (arrowheads).

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Figure 2.

(a) Axial and (b) coronal chest CT images evincing the intrathoracic rib (arrowheads). (c) Three-dimensional volume reconstruction chest CT image of the right lung demonstrates the parenchymal indentation of the intrathoracic rib (arrows).

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An intrathoracic rib, also known as a thoracic rib or slipping rib syndrome, is an extremely rare anomaly of the chest wall in which a normal, supernumerary or bifid rib is located within the chest cavity.1 The clinical manifestations of intrathoracic rib can include sharp or dull pain, difficulty breathing or shortness of breath and a palpable lump or bulge near the involved rib.1 The management of this type of malformation typically involves a combination of conservative measures and, in severe cases, surgical intervention.2 A chest CT scan allows precise visualization of the tubular shape and curvature of the intrathoracic rib and can be used to guide surgery.1,2

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Three-dimensional reconstruction CT scan of the chest showing the protrusion of the intrathoracic rib into the chest cavity.

References
[1]
X. Xue, S. Zhao, K. Li, B. Zhao.
Intrathoracic rib: rare rib anomaly, review of the literature and proposal for classification.
Int J Med Sci, 18 (2021), pp. 3800-3807
[2]
C. Wang, G. Hu, B. Min, Z. Cheng, X. Zuo.
Single-port thoracoscopic intrathoracic rib resection: a case description.
Quant Imaging Med Surg, 13 (2023), pp. 507-511
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