Anterior rib bifurcation

Case contributed by Muhammad Shoyab
Diagnosis certain

Presentation

Cough

Patient Data

Age: 35 years
Gender: Male

X-Ray Chest P/A View

x-ray

Ground-glass haziness in lower zone of left lung field.

Bifurcation at anterior shaft of right 4th rib, with reduction of 3rd intercostal space.

Case Discussion

Intercostal space reduction is attributable to the absence of bony attachment site for the intercostal muscles. This also results in reduced lung expansion in this part, and may predispose to localized lung infection due to accumulation of secretions.

Rib bifurcation often raises concern for Gorlin syndrome, which commonly affects right 4th rib. However, at present, the patient demonstrates different features, i.e. inflammatory changes in left lung.

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