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At least 397 records · Page 22Linked to original sources
PubMed2005

Aneurysmal bone cyst of the rib in a child: report of a case.

An aneurysmal bone cyst (ABC) is a benign tumor of the skeletal system, which is rare in childhood and mostly occurs in long bones. An aneurysmal bone cyst of the rib is also very rare and it is difficult to distinguish from other rib tumors of childhood, especially Ewing's sarcoma. An unusual case of an aneurysmal bone cyst in the rib of a 12-year-old boy is presented herein. The entity is discussed with special emphasis on the clinicopathologic features, differential diagnosis, and treatment. The most important diagnostic aid in accurately identifying such cysts is to be aware of such a possible diagnosis when a child presents with a rib mass. An en bloc resection of the mass along with the affected portion of the rib is mandatory to obtain a satisfactory outcome.

Biopsy, Needle↗
PubMedDate not supplied

Cervical ribs: useful marker of monosomy X in fetal hydrops.

Cervical ribs were observed in six hydropic fetuses with 45X karyotype. To test the usefulness of this observation in the macerated hydropic fetus where chromosome culture is problematic, a group of 36 hydropic fetuses was examined. Cases were chosen to include fetuses with several karyotypic and pathological abnormalities known to be associated with fetal hydrops. Whole-body anteroposterior radiographs were evaluated without knowledge of the fetal karyotype or pathological findings. Twenty-five fetuses had an abnormal karyotype, seven had a normal karyotype and in four culture failed. In the last group, the number of X, 21 and 18 chromosomes per nucleus was estimated using FISH. Radiographic analysis demonstrated that among the 16 fetuses with 45,X karyotype or a single copy of X and female phenotype, 12 had a pair of cervical ribs. Three other fetuses had a single cervical rib. Only one fetus had no cervical ribs. The last fetus had tubular hypoplasia of the aortic arch and persistent mesocolon. Twelve of the sixteen 45,X fetuses had tubular hypoplasia of the aortic arch. Seven had other cardiovascular anomalies, five had renal anomalies, and five had anomalies of intestinal rotation. Cervical rib appears to be more common than other frequently recorded associations of 45,X. It is a useful and easily demonstrated mark in the evaluation of the macerated hydropic fetus.

Female↗
PubMed1983

Changes in rib cage shape during quiet breathing, hyperventilation and single inspirations.

We measured the relative changes in upper and lower rib cage volume (delta RCU and delta RCL, respectively) using an induction coil plethysmograph (Respitrace) in seven normal seated subjects during relaxed passive expiration from total lung capacity, during quiet breathing, rapid breathing at 60 breaths/min (RB), during exercise-induced hyperventilation (EH) and during single fast inspirations. The plot of the RCU vs RCL was slightly curvilinear during relaxation from total lung capacity in all subjects. However, the inferred changes in rib cage shape were similar during RB and EH to those observed during quiet breathing and the relaxation manoeuvres. In contrast, single rapid inspirations were associated with marked and variable changes in rib cage shape, being most prominent in the first part of the breath. Our results suggest that during cyclic breathing respiratory muscle activity is so co-ordinated that the pattern of rib cage shape change is similar to that observed during relaxation. In contrast, single rapid inspirations are associated with markedly different and variable shape changes of the rib cage, presumably due to different patterns of inspiratory muscle recruitment. The results are consistent with the observation that during tidal breathing regional ventilation distribution is flow independent.

Adult↗
PubMedDate not supplied

Intrathoracic fat. A new CT feature of intrathoracic rib. Case report.

A case of intrathoracic rib in a 55-year-old woman is described. A plain chest film showed a rib forking and a pleural based opacity. Computed tomography (CT) showed the lower arm of the rib fork to be "intrathoracic" and the pleural based opacity to be due to pleural tent and intrathoracic fat. Twenty cases have so far been reported, only few were studied by CT scan. The presence of intrathoracic fat has not previously been described in these cases. The types of intrathoracic rib including pseudo intrathoracic rib of newborn infants are discussed.

Adipose Tissue↗
PubMed2005

Thoracoscopic rib resection using a Gigli saw.

When a conventional approach is used to perform a rib resection, a skin incision longer than the rib to be resected must be made. As a result, a conventional rib resection leaves a rather large and esthetically unfavorable scar. After considering pain management, esthetics, and quality of life, we devised a new technique for thoracoscopic rib resection that uses a Gigli saw. This new technique was performed on an overweight woman with a solitary metastatic bone tumor of the right eighth rib, whose case is described herein. The patient's postoperative course was satisfactory. Since this technique does not require a long skin incision, pain management and aesthetic results are improved compared with conventional techniques.

Bone Neoplasms↗
PubMed2006

Automatic rib segmentation and labeling in computed tomography scans using a general framework for detection, recognition and segmentation of objects in volumetric data.

A system for automatic segmentation and labeling of the complete rib cage in chest CT scans is presented. The method uses a general framework for automatic detection, recognition and segmentation of objects in three-dimensional medical images. The framework consists of five stages: (1) detection of relevant image structures, (2) construction of image primitives, (3) classification of the primitives, (4) grouping and recognition of classified primitives and (5) full segmentation based on the obtained groups. For this application, first 1D ridges are extracted in 3D data. Then, primitives in the form of line elements are constructed from the ridge voxels. Next a classifier is trained to classify the primitives in foreground (ribs) and background. In the grouping stage centerlines are formed from the foreground primitives and rib numbers are assigned to the centerlines. In the final segmentation stage, the centerlines act as initialization for a seeded region growing algorithm. The method is tested on 20 CT-scans. Of the primitives, 97.5% is classified correctly (sensitivity is 96.8%, specificity is 97.8%). After grouping, 98.4% of the ribs are recognized. The final segmentation is qualitatively evaluated and is very accurate for over 80% of all ribs, with slight errors otherwise.

Algorithms↗
PubMed2004

Lateral thoracic expansion for Jeune syndrome: evidence of rib healing and new bone formation.

BACKGROUND: Lateral thoracic expansion is a procedure that has been described to enlarge the thoracic cage in patients with Jeune's asphyxiating thoracic dystrophy. The procedure involves separating ribs from their periosteum and plating them together in an expanded fashion with titanium struts. We have speculated that the ribs heal in this situation, despite the absence of surrounding periosteum, and that new rib formation occurs in the liberated periosteum. METHODS: Radiographic studies of patients who have undergone lateral thoracic expansion were reviewed for evidence of rib healing or periosteal new bone formation. RESULTS: This study presents radiologic evidence that rib healing actually occurs, as does periosteal ossification. CONCLUSIONS: Lateral thoracic expansion creates additional chest wall that is formed of autologous tissue, fully healed, and not ultimately dependent on titanium struts.

Asphyxia Neonatorum↗
PubMed1985

Upper rib fractures following median sternotomy.

First and second rib fractures occurred in 11 (16%) of 69 patients undergoing median sternotomy. Although 6 patients had no symptoms related to the rib fractures, 5 patients had postoperative chest, shoulder, and arm pain suggestive of angina pectoris or postpericardiotomy syndrome. The correct diagnosis of pain related to postoperative upper rib fracture may be made by direct visualization of the fracture on supine anteroposterior radiographs, elicitation of pain by palpation of the rib or motion of the upper extremity, lack of response to nitroglycerin, and negative electrocardiogram and cardiac enzyme levels. Upper rib fractures following median sternotomy are usually radiographically detectable within the first three postoperative days. Placement of the Ankeney sternal retractor with the upper blade in a lower position (fourth intercostal space) may reduce the incidence of this postoperative complication.

Adult↗
PubMed1978

A radiological study of vertebral and rib malformations in children with myelomeningocele.

Postmortem radiographs from 112 infants with thoracolumbosacral or lumbosacral myelomeningoceles were surveyed for associated vertebral and rib malformations. Sixty-four exhibited a variety of anomalies including hemivertebrae, fused vertebral bodies, fused vertebral arches, fused ribs, absence of ribs and absence of vertebral bodies. Anomalies were commonly associated with the cranial end of a dysraphic spina bifida region; in addition hemivertebrae and rib fusion exhibited peak incidences centred around the seventh cervical and fourth thoracic vertebra respectively. Fusion of vertebral arch elements increased in frequency throughout the thoracic region towards T10. The twelfth pair of ribs were absent in 20% of cases. Apparent absence of vertebral bodies from the caudal end of the vertebral column was seen in 24% of the radiographs.

Female↗
PubMed1998

Age assessment by rib phase analysis in Turks.

The Işcan's phase method for the estimation of adult age at death from the sternal extremity of the fourth rib was introduced in 1983. Over the years, numerous tests have confirmed the reliability of this technique on varied samples. However, no large scale study has been conducted to test the application of this method on a modern white sample geographically, genetically, and culturally diverse from the American white database. Therefore, the purpose of this paper is to apply rib phase standards to a Turkish sample to test if the progression of morphological changes follow the same age sequence. Using a sample of 150 males and 144 females of known age at death, each rib was phased using the standards developed by Işcan and associates in 1984 and 1985. The phase estimations were then subject to an analysis of variance. The results of the study indicated that Turkish ribs show the same morphological characteristics that define the phases at nearly identical ages. Variation as measured by the standard deviation increased from phase 5 on in both sexes. In conclusion, this study demonstrated that the rib phase standards can be accurately applied to Turks. Investigations of this nature are vital because one cannot assume that a method developed from one group is applicable to a distant population, especially in medicolegal proceedings.

Adolescent↗
PubMedDate not supplied

Induction of supernumerary ribs with sodium salicylate.

Although many chemical agents induce supernumerary ribs (SNR), few efforts have been published examining the induction of SNR in the presence or absence of maternal toxicity and the effect of dose on SNR length. A single administration of sodium salicylate on Day 9 of pregnancy at different dose levels (120, 180, 240, and 300 mg/kg) was used to induce SNR in the thoracolumbar region. At 180, 240, and 300 mg/kg, body weight loss was observed for dams following the administration, associated with reduced food consumption. The mean litter incidence of SNR in the control groups ranged between 0 and 17.1% and in the treated groups (from 180 to 300 mg/kg) between 50.5 and 88.6%. At 120 mg/kg, no adverse effects were noted in dams and the incidence of SNR was in the range of the control groups. Furthermore, in the three highest dose groups, increased incidences of 27 presacral vertebrae (PSV) were noted. In most instances, fetuses with 27 PSV had extra ribs whereas fetuses with 26 PSV tended to have rudimentary ribs. The distinction of SNR between rudimentary and extra ribs is usually based on a ratio of the length of 14th to 13th rib of 0.50. However, this value does not reflect the separation of the apparent bimodal distribution of SNR induced by sodium salicylate. A ratio of 0.35, which corresponds to the superior limit of the SNR of control fetuses, seemed to better define the two populations of SNR.

Abnormalities, Drug-Induced↗
PubMed1999

[Histologic-histochemical and immunocytochemical investigations of cartilage canals in human rib cartilage].

In contrast to articular cartilage the hyaline rib cartilage takes up a special position due to its size, shape and the kind of mechanical stress as well. These facts may influence the metabolism of rib cartilage. In our histological, histochemical and immunohistochemical investigations on pieces of rib cartilages of 34 persons at the age of fourth fetal month up to 60 years we could regularly demonstrate cartilage canals containing blood vessels without any spatial or temporal relationship to degenerative changes in cartilage tissue. Many of these cartilage canals are located in the center of the rib cartilage. Blood vessels as well as neuronal structures in the connective tissue of cartilage canals were detected by means of antibodies against components of the vessel wall (Von Willebrand factor) and nerve fibers (PGP 9.5). Nerves may have sensoric or vasomotoric functions as well, and they may influence cell differentiation and regeneration processes, respectively. Cartilage can not be regarded as vascularized like other tissues, but cartilage canals may have great functional importance for the metabolism of rib cartilage.

Adolescent↗
PubMed2003

Transaxillary approach in thoracic outlet syndrome: the importance of resection of the first-rib.

OBJECTIVE: The aim of this study was to analyze the transaxillary surgical approach and results of thoracic outlet cases in our clinic in the light of the recent literature data. METHODS: Between 1996 and 2002 a series of 35 cases diagnosed as thoracic outlet syndrome (TOS) hospitalized and surgically treated in our clinic have been studied retrospectively. RESULTS: Twenty-six of our cases were females (75%) and the mean age was 25+/-1 (17-40 years). The most important symptom was localized pain in the arm. In 90% of the cases the Adson, hyperabduction and abduction external rotation (AER) tests were positive. There was paresthesia in 30 cases (85%), atrophy in 3 cases (10%), and cyanosis in 6 cases (20%). Preoperative electromyogram (EMG) was demonstrated as 56.7 m/s (50-65) and postoperative EMG was demonstrated as 65.1 m/s (60-71). Postoperative EMG values were significantly higher than the preoperative EMG values (p<0.001). All patients were operated using the transaxillary approach. A total number of 40 operations were performed. Upon radiological investigation (n=17) 50% of the patients were found to have cervical ribs. In 30 cases (85%) the results were very good and in four cases (12%) good, and in one case (3%) the results were bad. There was no recurrence and reoperation in the long term follow-up. CONCLUSION: Careful patient history and physical examination should be done by a team, which consists of thoracic surgeon, physical therapy specialist, and a neurologist. Total resection of the first-rib with periosteally should be preferred in all of these cases with accompanying pathologies such as cervical rib, fibrous ligaments, and scalenius muscles. The transaxillary approach has provided a good exposure for the resection of cervical ribs, the first-rib and excision of fibrous ligaments and scalenius muscle by a perfect cosmetic result. All the patients should be encouraged for 2 months of physical exercises starting from early postoperative period.

Adolescent↗
PubMed1999

Tumors of the ribs: experience with 47 cases.

OBJECTIVES: To emphasise the existing difficulties in differentiating benign from malignant rib tumours, and especially the problems that a clinical doctor encounters when dealing with a hyperplastic rib. METHODS: Forty-seven patients with rib tumour underwent surgery in a period of 12 years (1984-1996). In 40 cases (85%), the lesion was benign and in seven (15%) was malignant. Twenty-one benign tumours originated from cartilage and bone, seven were inflammatory, six originated from the bone marrow, and minor percentages (2.5-5%) had vascular, neurogenous, degenerative or miscellaneous origin. Three of the malignant tumours were primary chondrosarcomas and two were metastatic from kidney. The rest were metastatic from stomach (adeno-Ca), and skin (melanoma). The mean age in the benign group was 25.2 years and in the primary malignant group was 20.7 years. Related symptoms were pain (47%) and swelling (42.5%). One-third (32%) of the patients were asymptomatic and the lesion was accidentally found during routine chest radiography. All patients were treated surgically with wide excision of the tumour and the diagnosis was established histologically. RESULTS: Resection was complete and curative in all cases without recurrence. CONCLUSIONS: Since the likelihood of malignancy cannot be excluded, all rib tumours should be considered malignant until proven otherwise. Therefore, prompt intervention is necessary and wide and radical initial excision of the involved rib is advocated.

Adolescent↗
PubMed2003

Sex determination from the sternal end of the rib by osteometric analysis.

BACKGROUND: The aim of this study was to establish a sample group of Turkish population to determine sex from the sternal end of the ribs. Sex determination from the human skeleton bones is a simple and specific method. MATERIALS AND METHODS: The specimens consisted of right fourth (4th) ribs of 78 females and 173 males of known age, sex and race during 1994-1997 in Izmir, Turkey. A discriminant function analysis showed that the most helpful parameter in the young group was superior-inferior height (SIH), and both SIH and anterior-posterior breadth (APB) in the older group. Modified discriminant score formulae for both young and old groups to determine sex for Turkish population was calculated. RESULTS: The results indicated that the accuracy of sex determination was 88.6% in the young group (phase 1-4, age 15-32), 86.5% in the older group (phase 5-8, age 33-89). CONCLUSIONS: This study indicates that sexual dimorphism can be assessable by using a single rib, right fourth rib in a Turkish population from ages 13 to 89. SIH of the rib is the most reliable parameter; APB follows it.

Adolescent↗
PubMed1976

Dynamics of the chest wall during speech production: function of the thorax, rib cage, diaphragm, and abdomen.

Anteroposterior diameters of the rib cage and abdomen and esophageal and gastric pressures were measured in normal subjects in upright and supine body positions during respiratory maneuvers and utterance tasks. Data were charted in relative motion diagrams and various motion-pressure diagrams which enabled graphic solution for muscular pressures exerted by the chest wall and individually by the thorax, rib cage, diaphragm, and abdomen during utterances. Behaviors of the chest wall and its parts were found to depend upon lung volume, utterance loudness, body position, and utterance task. For utterances encompassing most of the vital capacity, chest wall effort was at first net inspiratory and later net expiratory. The former was governed predominately by the rib cage and the abdomen in the upright body position and by the diaphragm in the supine position. For conversational speech, chest wall effort was continuously expiratory, control being vested in the rib cage and the abdomen in the upright body position and typically in the rib cage alone in the supine position. Mechanisms operating during the utterances are discussed, particularly those involved with conversational speech production. We conclude that the abdomen occupies an especially important role in running conversational speech in that it mechanically tunes the diaphragm to increase the latter's inspiratory efficiency and thus enables man to minimally interrupt his ongoing speech for needed inspiratory pauses. We also discuss the relevance of our findings to clinical endeavors.

Abdomen↗
PubMed2001

Rib graft reconstruction versus osseointegrated prosthesis for microtia: a significant change in patient preference.

Until recently the options for reconstruction of the microtic ear were unsatisfactory and the ear was often left alone. With recent advances, both autologous rib reconstruction and osseointegration produce good quality results. It is our practice to offer all patients a choice of no surgery, autologous rib cartilage reconstruction or an osseointegrated prosthetic ear. This study reports on parental choice between the reconstructive options as assessed by questionnaire. Earlier patients who have had their surgery were compared with more recent patients who have chosen an option but are awaiting surgery. In the patients who have had surgery, seven (30%) chose a prosthetic ear and 16 (69.5%) chose rib cartilage reconstruction, compared to those patients that are awaiting surgery, four (11%) chose a prosthetic ear and 31 (88.6%) chose rib cartilage reconstruction. The results show a significant increase in the choice for rib cartilage reconstruction in those patients awaiting surgery. Although high quality autologous reconstruction is not widely available we feel it is important that parents are at least informed that it is an alternative to osseointegration and no surgery.

Child↗
PubMedDate not supplied

Thoracoscopic-assisted diaphragmatic hernia repair using a thoracic rib resection.

OBJECTIVE: To describe the surgical treatment of a dorsal diaphragmatic hernia in an adult horse using thoracic rib resection aided by thoracoscopy and a flank incision. STUDY DESIGN: Case report. ANIMAL POPULATION: One client-owned horse. RESULTS: A six-year-old Dutch warmblood gelding was admitted for colic-associated colonic incarceration in a diaphragmatic hernia. Seven weeks after the initial colic surgery, the gelding underwent surgery to repair the defect. Thoracoscopy and a flank incision were used to identify the location of the hernia and the subsequent site of rib resection. The stomach was adhered to the edges of the defect, leaving only a small residual hole. Resection of the 14th rib provided excellent exposure of the defect and closure of the remaining hernia. CONCLUSION AND CLINICAL RELEVANCE: Thoracic rib resection can provide access to diaphragmatic hernias in adult horses. Thoracoscopy or a flank incision, or both, may aid in determining which rib is best resected.

Animals↗