Images in Clinical Medicine
Intrathoracic Rib
N Engl J Med 2009; 361:2557December 24, 2009
- Article
A 67-year-old woman who had a history of breast cancer and who had undergone chemoradiotherapy 10 years earlier underwent routine follow-up chest radiography. The images revealed right axillary surgical clips from previous breast-cancer surgery (Panels A and B, arrows) and a vertically oriented structure similar in density to adjacent bone within the right hemithorax (Panels A and B, arrowheads). This finding was consistent with a supernumerary intrathoracic rib. Supernumerary intrathoracic ribs are most common on the right side and arise from abnormal segmentation of adjacent sclerotomes. Although the condition is usually asymptomatic, it can occasionally cause symptoms if it is associated with fibrous bands or connections to other structures. The presence of an intrathoracic rib is usually an incidental finding and does not warrant further evaluation or intervention.
Jonathan H. Chung, M.D.
Sudhakar N. Pipavath, M.D.
University of Washington, Seattle, WA
jchung2@u.washington. edu
