Figure 1
Teaching Case
SectionChest imaging
Case TypeAnatomy and Functional Imaging
AuthorsMark Yassa 1; Jayanth H. Keshavamurthy 2; April Wheeler 3; Eduardo J. Stincer 2
Connected authors
37 years, male
A 37-year-old patient had a chest radiograph performed for dyspnoea.
Pseudo rib articulation, a normal variant mimicking a lung nodule.
Pseudo lung nodule
Pseudo rib articulation
Lung nodule
Chest radiograph showed a nodule overlying the mid thoracic spine. A CT examination of the chest confirmed this to be a rib articulation between the left sixth and seventh ribs. This is a normal congenital anatomical variant.
A. Background
Ribs articulation or pseudo rib articulation is a normal anatomical variant that is often detected on CT of the chest. Sometimes rib articulation may mimic other anomalies and is difficult to define on chest radiographs [1]. A review of the chest anomalies found congenital rib anomalies in 544 men (1.4%), while other studies have found a higher percentage of up to 8% [2]
B. Clinical Perspective
Chest CT was performed to investigate the suspected nodule in the chest radiograph. The pseudo rib articulation between the left posterior sixth and seventh ribs was identified on the CT examination instead of a lung nodule.
C. Imaging Perspective
A nodule was suspected in the chest radiograph on the lateral view. A chest CT was recommended. CT of the chest showed a pseudo rib articulation between the left sixth and seventh ribs posteriorly, that is mimicking a pseudo lung nodule [3].
D. Take Home
Pseduo rib articulation is a normal congenital variant. No further follow-up is needed. It will mimic a lung nodule on the chest radiograph.
Written informed patient consent for publication has been obtained.
Ribs articulation or pseudo rib articulation is a normal anatomical variant that is often detected on CT of the chest. Sometimes rib articulation may mimic other anomalies and is difficult to define on chest radiographs [1]. A review of the chest anomalies found congenital rib anomalies in 544 men (1.4%), while other studies have found a higher percentage of up to 8% [2]
B. Clinical Perspective
Chest CT was performed to investigate the suspected nodule in the chest radiograph. The pseudo rib articulation between the left posterior sixth and seventh ribs was identified on the CT examination instead of a lung nodule.
C. Imaging Perspective
A nodule was suspected in the chest radiograph on the lateral view. A chest CT was recommended. CT of the chest showed a pseudo rib articulation between the left sixth and seventh ribs posteriorly, that is mimicking a pseudo lung nodule [3].
D. Take Home
Pseduo rib articulation is a normal congenital variant. No further follow-up is needed. It will mimic a lung nodule on the chest radiograph.
Written informed patient consent for publication has been obtained.
References
[1] Alessandro Sias, Antonella Balestrieri, Carola Politi, Giorgio Mallarini (2006) Developmental articulation between the anterior ends of the first and second rib: normal anatomical variant. Eurorad case 5149
[2] Adam R. Guttentag, Julia K. Salwen (1999) Keep Your Eyes on the Ribs: The Spectrum of Normal Variants and Diseases That Involve the Ribs. Radio Graphics Vol. 19, No. 5 (PMID: 10489169)
[3] Theodore E. Keats, Mark W. Anderson (2013) Atlas of Normal Roentgen Variants That May Simulate Disease 9th Edition, P345
Case information
| URL: | https://www.eurorad.org/case/15913 |
| DOI: | 10.1594/EURORAD/CASE.15913 |
| ISSN: | 1563-4086 |
License
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
Figure 2
Keshavamurthy, J, Department of Radiology, Charlie Norwood VA, Augusta, GA
Figure 3
Keshavamurthy J, Charlie Norwood VA Medical Center, Augusta, Georgia, USA
Figure 4
Keshavamurthy J, Charlie Norwood VA, Augusta, GA, USA
