1st rib bifurcation with synostosis

Posted By Muhammad Shoyab
1st rib bifurcation with synostosis

Gender, Age

Male, 50

Diagnosis

1st rib bifurcation with synostosis

History

Cough, fever

Findings

#Bifurcation of right 1st rib at level of subclavian groove, followed by synostosis & sclerosis at anterior end — producing "hole-type" configuration. # Cervical rib on left side, forming pseudoarthrosis with left 1st rib. # Rudimentary cervical rib on right side.

Discussion

Reunion of the two divisions of a bifid rib has been called "hole" type by some authors. The 1st rib is a very unusual location for bifid ribs. Also unusual is the presence of bifid rib and cervical rib in the same patient. Although incomplete hole-type bifurcation of 1st rib has been reported earlier, complete hole-type bifurcation may not have been reported at all. As such, this case is among the very unique. Bifurcation of 1st rib at subclavian groove, as well as presence of true cervical rib forming pseudoarticulation with 1st rib (albeit on the opposite side) may predispose the patient to entrapment of neurovascular structures, and can lead to thoracic outlet syndrome. Nonetheless, presently these are incidental findings discovered when the patient is presenting with cold and fever.

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