Asymptomatic Rare Rib Anomalies: Cases of Rib Hypoplasia

Yıl 2010, Cilt: 15 Sayı: 2, 104 - 106, 01.04.2010

Mehmet Oğuzhan Özyurtkan

Öz

There are various types of congenital anomalies and deformities of the ribs, including the developmental fusion of two or more ribs, the articulation or bridge formation between two ribs, bifid rib (forked rib) and hypoplastic/aplasic rib. These morphologic anomalies and anatomic variants occur in 0.15%–0.31% of the population. Here in this paper, three patients with rib hypoplasia were reported as examples of these rare asymptomatic anomalies. The chest X-rays of three soldiers presenting with several other complaints revealed rib hypoplasias. None of the patients had a congenital disease, and they had no complaints related to these rib hypoplasias. As it is known, these rare rib anomalies are usually of little or no clinical significance; however, any physician dealing with the lung and the chest wall should be familiar with these rare anomalies to distinguish them from any tumoral or inflammatory rib diseases, and the chest X-rays should be examined very carefully to detect such asymptomatic rib anomalies.

Anahtar Kelimeler

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Asemptomatik Nadir Kosta Anomalileri: Kosta Hipoplazileri Olguları

Öz

Kostaların bilinen konjenital anomalileri ve deformiteleri arasında kosta füzyonları, iki kot arasında köprü oluşumu olması, bifid kostalar ve hipoplazik/aplazik kostalar sayılabilir. Bu morfolojik anomaliler ile anatomik varyasyonlar toplumda %0.15-0.31 arasında görülürler. Bu tür asemptomatik anomalilere örnek olması amacıyla yazıda kosta hipoplazisi mevcut olan üç vaka sunulmuştur. Farklı şikayetlerle hastaneye başvuran üç askerin akciğer grafilerinde kostal hipoplaziler görülmüştür. Hastaların hiçbirinde bir konjenital sendrom saptanmamıştır ve hipoplazilerin yarattığı bir şikayet mevcut değildir. Bilindiği üzere bu tür asemptomatik nadir kosta anomalilerinin genelde klinik önemi bulunmamaktadır, fakat tümöral veya inflamatuar kosta hastalıkları ile karıştırılmamaları için akciğer veya göğüs duvarıyla ilgilenen hekimler tarafından bilinmeleri ve akciğer grafilerinin bu tür anomalileri gözden kaçırmamak için daha dikkatli incelenmeleri gerekmektedir.

Anahtar Kelimeler

Kas-iskelet sistemi anormallikleri, kostalar, torasik radyoloji

Kaynakça

• Kurihara Y, Yakushiji YK, Matsumoto J, Ishikawa T, Hirata K. The Ribs: Anatomic and radiologic considerations. Radiographics 1999; 19: 105-119.
• Guttentag AR, Salwen JK. Keep your eyes on the ribs: The spectrum of normal variants and Diseases that involve the ribs. Radiographics 1999; 19: 1125-1142.
• Etter LE. Osseous abnormalities in the thoracic cage seen in forty thousand consecutive chest photoroentgenograms. Am J Roentgenol Radium Ther 1944; 51: 359-363.
• Özyurtkan MO. Asymptomatic rare rib anomalies: Bifid rib and rib fusion. J Clin Anal Med 2010; 1: 47-49.
• Durak D, Eren B, Fedakar R, Turkmen N. Congenital anomalies of the ribs: ana autopsy case report. Bratisl LekListy 2009; 110: 580-581.
• Apaydin M, Sarsilmaz A, Varer M. Third accessory (supernumerary) intrathoracic right rib. Surg Radiol Anat 2009; 31: 641-643.
• Merks JHM, Smets AM, Van Rijn RR, et al. Prevalence of rib anomalies in normal Caucasian children and childhood cancer patients. Eur J Med Gen 2005; 48: 113-129.
• Glass RBJ, Norton KI, Mitre SA, Kang E. Pediatric ribs: a spectrum of abnormalities. Radiographics 2002; 22: 87-104.
• Cagli K, Özcakar L, Beyazit M, Sirmali M. Thoracic outlet syndrome in an adolescent with bilateral bifid ribs. Clin Anat 2006; 19: 558-560.
• Edwards DK 3rd, Berry CC, Hilton SW. Trisomy 21 in newborn infants: chest radiographic diagnosis. Radiology 1988; 167: 317-318.
• Grangé G, Tantau J, Acuna N, Viot G, Narcy F, Cabrol D. Autopsy findings related to Down’s syndrome: 101 cases. J Gynecol Obstet Biol Reprod (Paris). 2006; 35: 477-482.
• Kato H, Kiyokawa H, Inoue H, Kobayashi S, Nishizawa O Anatomical reconsideration to renal area: lessons learned from radical nephrectomy or adrenalectomy through a minimal incision over the 12th rib.. Int J Urol 2004; 11: 709-713.
• Kato H, Nishizawa O. Supracostal approach- an excellent exposure for renal and adrenal surgery. Acta Urol Jpn 2001; 47: 449-452.
• Fokin AA, Robicsek F. Poland’s syndrome revisited. Ann Thorac Surg 2002; 74: 2218-2225.