Research Article
BibTex RIS Cite

Bifid ribs: a comprehensive review

Year 2016, Volume: 10 Issue: 3, 221 - 227, 30.12.2016

Abstract

Bifid or bifurcated ribs are a rare anatomical anomaly that accounts for approximately 28% of known rib abnormalities. Bifurcation always occurs at the sternal end of the rib and its two extremities are joined to a bifid costal cartilage. The presence of bifid rib is frequently accompanied by other anomalies, although this does not necessarily imply that it cannot occur as an isolated anomaly. The clinical significance of the latter has not been established. There have not been many studiesdone to investigate bifid rib closely aside from individual case reports, presumably due to the condition’s extremely low incidence. However the detection of bifid ribs, though mostly incidental, has been proven advantageous for an early and wellrounded diagnosis It has also revealed significant preventive benefits especially in the pediatric patient population. This review is written to provide a comprehensive summary of what is known about bifid ribs and incorporate substantial findings from clinical cases that have been reported in past literature.

References

  • 1. Wattanasirichaigoon D, Prasad C, Schneider G, Evans JA, Korf BR. Rib defects in patterns of multiple malformations: a retrospective review and phenotypic analysis of 47 cases. Am J Med Gen 2003; 122A:63–9.
  • 2. Silverman FN, Kuhn JP, editors. Caffey’s pediatric x-ray diagnosis: an integrated/imaging approach. 9th ed. St. Louis (MO): Mosby; 1993.
  • 3. Rathinasabapathi MK, Perumallapalli HK. Bifid rib: a rare anomaly. Medical Journal of Dr. D.Y. Patil University 2015;8:670–1.
  • 4. Song WC, Kim SH, Park DK, Koh KS. Bifid rib: anatomical considerations in three cases. Yonsei Med J 2009;50:300–3.
  • 5. Etter LE. Osseous abnormalities in the thoracic cage seen in forty thousand consecutive chest photoroentgenograms. Am J Roentgenol Radium Ther 1944;51:359–63.
  • 6. Patil VA, Lal V, Shaikh TP, Narayan P, Deolekar S. A rare case of bilateral bifid ribs: a case report. International Journal of Research in Medical Sciences 2014;2:1783–4.
  • 7. Osawa T, Sasaki T, Matsumoto Y, Tsukamoto A, Onodera M, Nara E, Chen J-K, Fujimura A, Nozaka Y. Bifid ribs observed in the third and the fourth ribs. Kaibogaku Zasshi 1998;73:633–5.
  • 8. Oostra RJ, Maas M. Bifid ribs and unusual vertebral anomalies diagnosed in an anatomical specimen. Am J Med Genet A 2006;140: 2135–8.
  • 9. Spörle R, Schughart K. Paradox segmentation along inter- and intrasomitic borderlines is followed by dysmorphology of the axial skeleton in the open brain (opb) mouse mutant. Dev Genet 1998;22:359– 73.
  • 10. Schumacher R, Mai A, Gutjahr P. Association of rib anomalies and malignancy in childhood. Eur J Pediatr 1992;151:432–4.
  • 11. Gorlin RJ, Goltz RW. Multiple nevoid basal-cell epithelioma, jaw cysts, and bifid rib: a syndrome. N Engl J Med 1960;262:908–12.
  • 12. Koutnik AW, Kolodny SC, Hooker SP, Roche WC. Multiple nevoid basal cell epithelioma, cysts of the jaw, and bifid rib syndrome: report of a case. J Oral Surg 1975;33:686–9.
  • 13. Suemori H, Takahashi N, Noguchi S. Hoxc-9 mutant mice show anterior transformation of the vertebrae and malformation of the sternum and ribs. Mech Dev 1995;51:265–73.
  • 14. Zhang W, Behringer RR, Olsen EN. Inactivation of the myogenic bHLH gene MRF4 results in up-regulation of myogenin and rib anomalies. Genes Dev 1995;9:1388–99.
  • 15. Martin EJ. Incidence of bifidity and related rib abnormalities in Samoans. Am J Phys Anthropol 1960;18:179–87.
  • 16. Kimonis VE, Mehta SG, DiGiovanna JJ, Bale SJ, Pastakia B. Radiological features in 82 patients with nevoid basal cell carcinoma (NBCC or Gorlin) syndrome. Genet Med 2004;6:495–502.
  • 17. Stickley CD, Tamura K, Labrash SJ, Lozanoff S. Bifurcation of the fourth rib as a possible indicator of Gorlin’s syndrome in an 85-yearold female cadaver. International Journal of Anatomical Variations 2013;6:86–9.
  • 18. Yunis JJ, Gorlin RJ. Chromosomal study in patients with cysts of the jaw, multiple nevoid basal cell carcinomata and bifid rib syndrome. Chromosoma 1963;14:146–53.
  • 19. Rist E, Gally L, Trocme C. L’ossification des cartilages costauxdansl’especehumaine. Presse Medicale 1928;36:641–4.
  • 20. Glass BJ, Norton KI, Mitre SA, Kang E. Pediatric ribs: a spectrum of abnormalities. Radiographics 2002;22:87–104. 21. Bottosso N, Ghaye B. Bifid intrathoracic rib. JBR-BTR 2008;91:86– 7.
  • 22. Kamano H, Ishihama T, Ishihama H, Kubota Y, Tanaka T, Satoh K. Bifid intrathoracic rib: a case report and classification of intrathoracic ribs. Intern Med 2006;45:627–30.
  • 23. Kupeli E, Ulubay G. Bony bridge of a bifid rib. Clev Clin J Med 2010;77:232–3.
  • 24. Scheepers S, Andronikou S. Beware the bifid rib. South African Journal of Radiology 2010;14:104.
  • 25. Martinez-Frias ML, Frias JL, Opitz JM. Errors of morphogenesis and developmental field theory. Am J Med Genet 1998;76:291–6.
  • 26. Meerkotter VA, Shear M. Multiple primordial cysts associated with bifid rib and ocular defects. Oral Surg Oral Med Oral Pathol 1964; 18:498–503.
  • 27. Binkley GW, Johnson HH Jr. Epithelioma adenoids cysticum: basal cell nevi. agenesis of corpus callosum and dental cysts. AMA Arch Derm Syphilol 1951;63:73–84.
  • 28. Gross PP. Epithelioma adenoides cysticum with follicular cysts of maxilla and mandible. J Oral Surg (Chic) 1953;11:160–5.
  • 29. Schamberg IL. Basal cell nevi. Arch Dermatol 1960;81:269. 30. Cagli K, Ozcakar L, Beyazit M, Sirmali M. Thoracic outlet syndrome in an adolescent with bilateral bifid ribs. Clin Anat 2006;19: 558–60.
  • 31. Guttentag AR, Salwen JK. Keep your eyes on the ribs: the spectrum of normal variants and diseases that involve the ribs. Radiographics 1999;19:1125–42.
  • 32. Bloomberg MW. Bifurcate ribs - an unusual cause of deformity of the chest. Can Med Assoc J 1926;16:807–8.
  • 33. Batra D, Lawner BJ. Bifid fifth rib in a 9-year-old girl with chest pain. J Am Osteopath Assoc 2006;106:359–60.
Year 2016, Volume: 10 Issue: 3, 221 - 227, 30.12.2016

Abstract

References

  • 1. Wattanasirichaigoon D, Prasad C, Schneider G, Evans JA, Korf BR. Rib defects in patterns of multiple malformations: a retrospective review and phenotypic analysis of 47 cases. Am J Med Gen 2003; 122A:63–9.
  • 2. Silverman FN, Kuhn JP, editors. Caffey’s pediatric x-ray diagnosis: an integrated/imaging approach. 9th ed. St. Louis (MO): Mosby; 1993.
  • 3. Rathinasabapathi MK, Perumallapalli HK. Bifid rib: a rare anomaly. Medical Journal of Dr. D.Y. Patil University 2015;8:670–1.
  • 4. Song WC, Kim SH, Park DK, Koh KS. Bifid rib: anatomical considerations in three cases. Yonsei Med J 2009;50:300–3.
  • 5. Etter LE. Osseous abnormalities in the thoracic cage seen in forty thousand consecutive chest photoroentgenograms. Am J Roentgenol Radium Ther 1944;51:359–63.
  • 6. Patil VA, Lal V, Shaikh TP, Narayan P, Deolekar S. A rare case of bilateral bifid ribs: a case report. International Journal of Research in Medical Sciences 2014;2:1783–4.
  • 7. Osawa T, Sasaki T, Matsumoto Y, Tsukamoto A, Onodera M, Nara E, Chen J-K, Fujimura A, Nozaka Y. Bifid ribs observed in the third and the fourth ribs. Kaibogaku Zasshi 1998;73:633–5.
  • 8. Oostra RJ, Maas M. Bifid ribs and unusual vertebral anomalies diagnosed in an anatomical specimen. Am J Med Genet A 2006;140: 2135–8.
  • 9. Spörle R, Schughart K. Paradox segmentation along inter- and intrasomitic borderlines is followed by dysmorphology of the axial skeleton in the open brain (opb) mouse mutant. Dev Genet 1998;22:359– 73.
  • 10. Schumacher R, Mai A, Gutjahr P. Association of rib anomalies and malignancy in childhood. Eur J Pediatr 1992;151:432–4.
  • 11. Gorlin RJ, Goltz RW. Multiple nevoid basal-cell epithelioma, jaw cysts, and bifid rib: a syndrome. N Engl J Med 1960;262:908–12.
  • 12. Koutnik AW, Kolodny SC, Hooker SP, Roche WC. Multiple nevoid basal cell epithelioma, cysts of the jaw, and bifid rib syndrome: report of a case. J Oral Surg 1975;33:686–9.
  • 13. Suemori H, Takahashi N, Noguchi S. Hoxc-9 mutant mice show anterior transformation of the vertebrae and malformation of the sternum and ribs. Mech Dev 1995;51:265–73.
  • 14. Zhang W, Behringer RR, Olsen EN. Inactivation of the myogenic bHLH gene MRF4 results in up-regulation of myogenin and rib anomalies. Genes Dev 1995;9:1388–99.
  • 15. Martin EJ. Incidence of bifidity and related rib abnormalities in Samoans. Am J Phys Anthropol 1960;18:179–87.
  • 16. Kimonis VE, Mehta SG, DiGiovanna JJ, Bale SJ, Pastakia B. Radiological features in 82 patients with nevoid basal cell carcinoma (NBCC or Gorlin) syndrome. Genet Med 2004;6:495–502.
  • 17. Stickley CD, Tamura K, Labrash SJ, Lozanoff S. Bifurcation of the fourth rib as a possible indicator of Gorlin’s syndrome in an 85-yearold female cadaver. International Journal of Anatomical Variations 2013;6:86–9.
  • 18. Yunis JJ, Gorlin RJ. Chromosomal study in patients with cysts of the jaw, multiple nevoid basal cell carcinomata and bifid rib syndrome. Chromosoma 1963;14:146–53.
  • 19. Rist E, Gally L, Trocme C. L’ossification des cartilages costauxdansl’especehumaine. Presse Medicale 1928;36:641–4.
  • 20. Glass BJ, Norton KI, Mitre SA, Kang E. Pediatric ribs: a spectrum of abnormalities. Radiographics 2002;22:87–104. 21. Bottosso N, Ghaye B. Bifid intrathoracic rib. JBR-BTR 2008;91:86– 7.
  • 22. Kamano H, Ishihama T, Ishihama H, Kubota Y, Tanaka T, Satoh K. Bifid intrathoracic rib: a case report and classification of intrathoracic ribs. Intern Med 2006;45:627–30.
  • 23. Kupeli E, Ulubay G. Bony bridge of a bifid rib. Clev Clin J Med 2010;77:232–3.
  • 24. Scheepers S, Andronikou S. Beware the bifid rib. South African Journal of Radiology 2010;14:104.
  • 25. Martinez-Frias ML, Frias JL, Opitz JM. Errors of morphogenesis and developmental field theory. Am J Med Genet 1998;76:291–6.
  • 26. Meerkotter VA, Shear M. Multiple primordial cysts associated with bifid rib and ocular defects. Oral Surg Oral Med Oral Pathol 1964; 18:498–503.
  • 27. Binkley GW, Johnson HH Jr. Epithelioma adenoids cysticum: basal cell nevi. agenesis of corpus callosum and dental cysts. AMA Arch Derm Syphilol 1951;63:73–84.
  • 28. Gross PP. Epithelioma adenoides cysticum with follicular cysts of maxilla and mandible. J Oral Surg (Chic) 1953;11:160–5.
  • 29. Schamberg IL. Basal cell nevi. Arch Dermatol 1960;81:269. 30. Cagli K, Ozcakar L, Beyazit M, Sirmali M. Thoracic outlet syndrome in an adolescent with bilateral bifid ribs. Clin Anat 2006;19: 558–60.
  • 31. Guttentag AR, Salwen JK. Keep your eyes on the ribs: the spectrum of normal variants and diseases that involve the ribs. Radiographics 1999;19:1125–42.
  • 32. Bloomberg MW. Bifurcate ribs - an unusual cause of deformity of the chest. Can Med Assoc J 1926;16:807–8.
  • 33. Batra D, Lawner BJ. Bifid fifth rib in a 9-year-old girl with chest pain. J Am Osteopath Assoc 2006;106:359–60.
There are 31 citations in total.

Details

Primary Language English
Subjects Health Care Administration
Journal Section Reviews
Authors

Andrea Andrea This is me

Gabrielle Tardieu This is me

Christian Fisahn This is me

Joe Iwanaga This is me

Rod J. Oskouian This is me

R. Shane Tubbs This is me

Publication Date December 30, 2016
Published in Issue Year 2016 Volume: 10 Issue: 3

Cite

APA Andrea, A., Tardieu, G., Fisahn, C., Iwanaga, J., et al. (2016). Bifid ribs: a comprehensive review. Anatomy, 10(3), 221-227.
AMA Andrea A, Tardieu G, Fisahn C, Iwanaga J, Oskouian RJ, Tubbs RS. Bifid ribs: a comprehensive review. Anatomy. December 2016;10(3):221-227.
Chicago Andrea, Andrea, Gabrielle Tardieu, Christian Fisahn, Joe Iwanaga, Rod J. Oskouian, and R. Shane Tubbs. “Bifid Ribs: A Comprehensive Review”. Anatomy 10, no. 3 (December 2016): 221-27.
EndNote Andrea A, Tardieu G, Fisahn C, Iwanaga J, Oskouian RJ, Tubbs RS (December 1, 2016) Bifid ribs: a comprehensive review. Anatomy 10 3 221–227.
IEEE A. Andrea, G. Tardieu, C. Fisahn, J. Iwanaga, R. J. Oskouian, and R. S. Tubbs, “Bifid ribs: a comprehensive review”, Anatomy, vol. 10, no. 3, pp. 221–227, 2016.
ISNAD Andrea, Andrea et al. “Bifid Ribs: A Comprehensive Review”. Anatomy 10/3 (December 2016), 221-227.
JAMA Andrea A, Tardieu G, Fisahn C, Iwanaga J, Oskouian RJ, Tubbs RS. Bifid ribs: a comprehensive review. Anatomy. 2016;10:221–227.
MLA Andrea, Andrea et al. “Bifid Ribs: A Comprehensive Review”. Anatomy, vol. 10, no. 3, 2016, pp. 221-7.
Vancouver Andrea A, Tardieu G, Fisahn C, Iwanaga J, Oskouian RJ, Tubbs RS. Bifid ribs: a comprehensive review. Anatomy. 2016;10(3):221-7.

Anatomy is the official journal of Turkish Society of Anatomy and Clinical Anatomy (TSACA).