Presentation
Radiographs were obtained after two weeks of left rib pain (approx T7 to T10) following a fall.
Patient Data
This normal study shows multiple views of the ribs and a PA chest radiograph.
No rib fractures were found (new or healing). The bony thorax and the thoracic viscera are normal.
Case Discussion
This case shows the normal appearance of the bony thorax (left hemithorax). Linear areas of calcification in the costal cartilage along the anterior aspect of the lower ribs are a very frequent and normal finding. This patient can see it at the anterior aspect of ribs T7, T8, T9, and T10.
The AP view centered around T7 demonstrates the posterior aspect of the ribs above the diaphragm and is obtained with the patient in suspended full inspiration.
The AP view centered around T12 demonstrates the posterior aspect of the ribs below the diaphragm. The radiograph is taken with suspended respiration at the end of exhalation to raise the diaphragm.
The corresponding AP oblique views (above or below the diaphragm) best demonstrate the axillary portion of the ribs because it removes the superposition of the posterior ribs.
The PA oblique view allows the evaluation of the lateral aspect of most ribs and is obtained in full inspiration.
A metallic marker was placed on the patient to pinpoint the pain location. It is not visualized on most of the submitted images as it was cropped out during image processing. It can be only be seen on the AP oblique of the upper ribs. The left marker was also cropped out for identification reasons.
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