PMC3876714_01
43-year-old gentleman complaining of high grade fever, cough, and chest pain was investigated with chest radiographs and helical chest CT scan and subsequently diagnosed with intrathoracic ribs. Chest radiograph shows left upper and mid-zone opacity (black arrows) and depression of bifid left third rib (white arrows). Upper lobe of the left lung is hypoplastic.
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The chest radiograph revealed a triangular opacity in the left upper and mid zones laterally (Figure 1). Additionally, depression of left third rib was noted leading to a suspicion of a rib abnormality (Figure 1).
43-year-old gentleman complaining of high grade fever, cough, and chest pain was investigated with chest radiographs and helical chest CT scan and subsequently diagnosed with intrathoracic ribs. Unenhanced axial chest CT scan (bone window) shows depressed left third intrathoracic rib (arrows) and hypoplastic upper lobe of the left lung.
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CT scan images demonstrate hypoplastic left upper lung lobe (Figure 2). CT scan images also reveal fusion of anterior aspects of the The thick horizontally oriented depressed structure originating from the third costovertebral articulation appears to be a depressed normonumerary third rib (Figures 2, 3(a), 3(b), and 4(a)).
43-year-old gentleman complaining of high grade fever, cough, and chest pain was investigated with chest radiographs and helical chest CT scan and subsequently diagnosed with intrathoracic ribs. Unenhanced chest CT, volume rendered-3D images, coronal view in (a) and coronal oblique view in (b) reveal fusion of anterior aspects of the T2 and T3 vertebral bodies (short black arrow), a supernumerary second rib (thin, short, and obliquely oriented) with predominantly fibrous (non-ossified) proximal and distal parts originating from the second costovertebral neoarticulation (short white arrow), and the obliquely oriented bifid arm of the third rib coursing into the thoracic cavity (long white arrow).
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T3 vertebral bodies (Figures 3(a) and 3(b)). Two abnormal ribbon shaped bony structures are noted originating from the second and the third costovertebral articulations, respectively, on the left side (Figures 3(a) and 3(b)). The thin, short, and obliquely oriented structure originating from the second costovertebral articulation (separate from the second rib:neoarticulation) appears to be a supernumerary/accessory second rib coursing into the thoracic cavity. Its proximal and distal parts are predominantly fibrous (nonossified) (Figures 3(a) and 3(b)). The thick horizontally oriented depressed structure originating from the third costovertebral articulation appears to be a depressed normonumerary third rib (Figures 2, 3(a), 3(b), and 4(a)). The obliquely oriented bifid arm of the third rib is thick and courses into the thoracic cavity (Figures 3(a), 3(b), and 4(b)).
43-year-old gentleman complaining of high grade fever, cough, and chest pain was investigated with chest radiographs and helical chest CT scan and subsequently diagnosed with intrathoracic ribs. Unenhanced axial chest CT scans with bone window in (a) and mediastinal window in (b) show prominent extrapleural soft tissue including fat around the left intrathoracic rib (arrow).
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Prominent extrapleural soft tissue including fat is noted along the intrathoracic rib-like structures (Figures 5(a) and 5(b)).