Search

The article focuses on the diagnosis of medical condition "12th rib syndrome" for acute and chronic flank pain. It suggests that the condition should be considered in examining of patients with history of stone formation of urinary tract calculus. Most cases reported were unilateral and its pathophysiology can be related to loose costo-chondral cartilages or inflammation of the tendinous insertions in the ribs. It also discusses a treatment which can afford short term pain relief to patients.

The article invites readers to discuss the clinical case of a four month old infant who was hospitalized with a mass in the right lower chest wall. The mass, present since birth, was fixed to the chest wall and had a hard consistency. A chest radiograph and contrast enhanced computed tomography (CT) of the chest was performed on the patient. Chest radiograph revealed that right seventh rib was expanded with erosion of the cortex and adjacent ribs were splayed.

The article offers information on a ten-week female Golden Retriever dog with a history of deformities of the thorax and limbs. It was unable to stand and was small for its age. The dog was in respiratory distress and the joints of the limbs were large. The deformity of the ribs and sternum resulted in cranial and right lateral displacement of the cardiac silhouette and diaphragm. The owner of the dog reuested that it be euthanized because of the poor prognosis.

An abstract of the article "Is the rib hump (thoracic/surface deformity) always in agreement with the Cobb angle (spinal/radiological deformity)? A study in school-screening referrals, with aetiological implications," is presented.

The article reports that the U.S. Food and Drug Administration recently approved the Vertical Expandable Prosthetic Titanium Rib (VEPTR), made by Synthes Spine Co., West Chester, Pennsylvania, and approved as a humanitarian device. This innovative new implant could extend the lives of patients suffering thoracic insufficiency syndrome in pediatric patients. Thoracic insufficiency syndrome is a congenital condition where severe deformities of the chest, spine, and ribs prevent normal breathing and lung growth and development. The VEPTR device is a curved metal rod that is attached to ribs near the spine using hooks located at both ends of the device.

Reports on the use of magnetic stimulation of the phrenic nerves to facilitate management of the persisting supplementary oxygen requirement of an infant with lumbocostovertebral syndrome. Role of diaphragm testing in determining the management of respiratory problems of infants with multiple anomalies; Medical history of the infant's mother; Results of the infant's lung volume measurement.

Objective Minimally invasive repair of pectus excavatum (MIRPE) and pectus carinatum (MIRPC) have gained wide acceptance during the last years. This study compares, retrospectively, the experience at 58 minimal invasive procedures, and 80 Ravitch repair. Methods Between 2004-2015, 49 PE (pectus excavatum) and 9 PC (pectus carinatum) patients underwent minimal invasive and 80 underwent Ravitch procedure. Ages were ranged 6 to 36 years (mean 17,2) for MIRPE, and 10 to 22 years (mean 17) for Ravitch. The mean pectus severity index was 3,2 for MIRPE and 4,7 for Ravitch. Results There were no deaths. Complications were occured in 4 patients for Ravitch and 8 for Nuss procedure. Preoperative echocardiography was noted 7.3% mild mitral valve prolapse for Ravich procedure and no cardiac abnormalities for Nuss procedure. Complications in Ravitch; pneumothorax in 5.1% hea-mothorax in 2.6%, chest discomfort in 57%, pleural effusion in 2.6%, and sternal hypertrophic scar in 27%; Nuss procedure had 3,7% wound infections, no pleural effusion,1,8% pneumothorax. Mean operating time was 2,5 hours for Ravitch and one hour for Nuss procedure. Mean hospitalization was 8 days for Ravitch and 4,6 days for Nuss procedure. Mean time of return to work or school was 15 days for Ravitch and 10 days for Nuss procedure. Two patients' barrwas removed because of displacement, and one barr was removed because of chest pain. Conclusions The Nuss procedure has several advantages over the Ravitch method. Especially with regard to the cosmetics of the surgical wound Ravitch has a longer operating time and increased hospital stay, and complication rate is higher than Nuss procedure. [ABSTRACT FROM AUTHOR]

Objective We aimed to present the results of our series of 58 patients operated using minimal invasive reconstruction of pectus excavatum and minimal invasive reconstruction of pectus carinatum. Methods Fifty-eight patients were operated on between May 2011 -May 2015 by Selcuk University Medical Faculty Thoracic Division. Fifty-one males and 7 females were included, mean age 17,2 years. Forty-one of patients presented cosmetic indication. Other 17 patients were considered to have severe form of pectus excavatum, with recurrent respiratory infections and palpitation because of cardiac and pulmonary compression. Single implant was used on 57 patients. We performed Abramson procedure in 9 patients with pectus carinatum. Surgery was performed with right lung exclusion via thoracoscopy in 49 cases with PE. Other 2 patients performed on the left sides. Two patients were performed Nuss procedure due to recurrence after open surgery three years later. Results The cosmetic results were satisfied by 48 patients. Two patients presented complications pneumo- thorax and prolonged the air drainage. We follow -up the cases 3 years and we removed the barr in 19 patients after first surgery in the time of about 22 months (4-39 months). Two patients' barr was removed because of barr malposition on 4th month, and one barr was removed for chest pain on 6th month. Conclusions For patients it may be useful approach of left-side thoracoscopy risk of lacerations of heart and vessels. Elderly patients should be given height level of barr curve. MIRPE technique is less invasive method, low complication rates, currently. This operation should be used securely. [ABSTRACT FROM AUTHOR]

The article discusses a rare medical case wherein a female infant was born with Pierre Robin sequence including cerebro-costo-mandibular syndrome caused by heterozygous mutation in the Small Nuclear Ribonucleoprotein Polypeptides B And B1 (SNRPB) gene on chromosome 20p13.

Background context Sacral rib represents an uncommon pathology in which rib-like structures arise from the sacrum. Supernumerary ribs may occur at any level of the spine, but supernumerary ribs in the sacrococcygeal area are extremely rare. Purpose To present the case of a patient with sacral rib and to discuss this entity with reference to the literature. Study design A case report and literature review. Methods A 17-year-old girl presented with low back pain and discomfort in bilateral gluteal regions. Radiographs and computed tomography (CT) of the pelvis showed a smooth-surfaced, rod-like bony structure attaching to the sacrum on the left side. The appearance was consistent with sacral rib. The sacrum was hypoplastic and deviated to the right. Magnetic resonance imaging (MRI) showed insertion of the gluteus maximus (GM) onto the coccyx only on the right side. The sacral rib existed beneath the left GM muscle and received a partial insertion from the left GM muscle. No ligamentous continuation between the sacral rib and coccyx was observed. Results Conservative treatment relieved symptoms, so no surgical intervention was performed. Conclusions Sacral rib is a rare congenital anomaly for which surgical intervention is usually unnecessary. However, appropriate workups with CT and/or MRI should be considered for women, because sacral rib may cause complications during childbirth. In the literature, sacral/coccygeal rib is sometimes called “pelvic rib.” However, sacral/coccygeal rib should be distinguished from pelvic rib, because pelvic rib originating from the ilium is considered to represent a different entity. [ABSTRACT FROM AUTHOR]

The case history is presented of a patient with neurofibromatosis with a chest wall defect present from birth. Abnormal rib development had resulted in a flail segment with painful paradoxical movement and unsightly costal cartilage protrusion. Chest wall reconstruction using Marlex mesh resulted in an excellent cosmetic and functional repair. [ABSTRACT FROM AUTHOR]

Background: The pathomechanism underlying idiopathic scoliosis remains unclear, and, to our knowledge, a consistent and relevant animal model has not been established previously. The goal of this study was to examine whether a disturbance of rib cage development is a causative factor for scoliosis and to establish a nonsurgical mouse model of progressive scoliosis. Methods: To examine the relationship between rib cage development and the pathogenesis of progressive scoliosis, a plastic restraint limiting anteroposterior rib cage development was placed on the chest of four-week-old mice. All mice were evaluated with whole-spine radiographs, and the severity of scoliosis was consecutively measured. The rib cage rotation angle and the anteroposterior chest dimension were measured with use of micro-computed tomography scanning. To examine whether the imbalanced load transmission through the ribs to the vertebral body was involved in our model, we performed a rib-neck osteotomy in a subgroup of the mice. Results: The thoracic restraint did not provoke spinal curvature immediately after it was applied, but nine often mice that wore the restraint but did not have rib osteotomy gradually developed progressive scoliosis. Radiographs and computed tomography images showed a right thoracic curvature, vertebral rotation, and narrow chest in the mice that had worn the restraint for eleven weeks but did not have rib osteotomy even after the restraint was removed. The anteroposterior chest dimension was significantly correlated with both the curve magnitude and the rib cage rotation angle. The progression of spinal deformity was observed only during the adolescent growth spurt, and it plateaued thereafter. The left-side rib osteotomy led to the development of progressive left-thoracic curvature, whereas the bilateral rib osteotomy did not cause scoliosis, even with restraint wear. Conclusions: We established a nonsurgical experimental model of progressive scoliosis and also demonstrated that a rib cage deformity with an imbalanced load to the vertebral body resulted in progressive structural scoliosis. [ABSTRACT FROM AUTHOR]

A case study of an eight-year-old afebrile boy is presented who had a history of running nose and coughing. His chest radiography revealed the caudal orientation of right third rib and mid-thorax. His helical thorax computed tomography (CT) demonstrated sloping of distal end of third rib. He was diagnosed for supernumerary intrathoracic rib, a rare congenital anomaly from abnormal segmentation of adjacent sclerotomes.

Several techniques exist for the repair of complex pectus excavatum. The placement of retrosternal metal bars improves the results by reducing the recurrence rate, but entails several possible risks, complications and disadvantages. A new method, specifically conceived for the repair of severe, asymmetric forms in adult patients, is reported. The corrected bone is fixed in the proper position by two, patient-customized, titanium struts, externally screwed to the manubrium and sternal body. Any retrosternal bar is thus avoided, reducing possible complications, without hampering the chest wall dynamic. In this particularly difficult issue, this technique provides long-term good functional, mechanical and cosmetic results and does not entail a second surgery for struts removal. [ABSTRACT FROM AUTHOR]

A letter to the editor is presented in response to the article "Prognostic factors in flail-chest patients," by K. Athanassiadi and colleagues in a 2010 issue.

Abstract: Objective: To assess the sensitivity and image quality of chest radiography (CXR) with or without dual-energy subtracted (ES) bone images in the detection of rib fractures. Materials and methods: In this retrospective study, 39 patients with 204 rib fractures and 24 subjects with no fractures were examined with a single exposure dual-energy subtraction digital radiography system. Three blinded readers first evaluated the non-subtracted posteroanterior and lateral chest radiographs alone, and 3 months later they evaluated the non-subtracted images together with the subtracted posteroanterior bone images. The locations of rib fractures were registered with confidence levels on a 3-grade scale. Image quality was rated on a 5-point scale. Marks by readers were compared with fracture localizations in CT as a standard of reference. Results: The sensivity for fracture detection using both methods was very similar (34.3% with standard CXR and 33.5% with ES-CXR, p =0.92). At the patient level, both sensitivity (71.8%) and specificity (92.9%) with or without ES were identical. Diagnostic confidence was not significantly different (2.61 with CXR and 2.75 with ES-CXR, p =0.063). Image quality with ES was rated higher than that on standard CXR (4.08 vs. 3.74, p <0.001). Conclusions: Despite a better image quality, adding ES bone images to standard radiographs of the chest does not provide better sensitivity or improved diagnostic confidence in the detection of rib fractures. [Copyright &y& Elsevier]

The article discusses a case of a 72-year-old man who was presented with chronic obstructive pulmonary disease (COPD). It says that the patient experiences retraction of the lower rib cage margin and the chest radiograph presented distention of the lungs associated with the flattening of the diaphragm. It also mentions that expiratory flow limitation results to incomplete gas trapping and emptying of the lungs that induces pulmonary hyperinflation which is the cause of diaphragm flattening.

The article presents a case study of an 18-year-old woman who suffered from weakness, pain and swelling of her left arm in Istanbul, Turkey. Results of her computed tomography (CT) angiography reveal that there was her cervical rib arises from the seventh cervical vertebra and it extended into the supraclavicular region. Moreover, it was found that the problem caused obstruction of her subclavian arterial lumen.

Abstract: An intrathoracic rib is a rare and benign congenital anomaly of the thoracic cage. We report the case of an intrathoracic rib in which its pericardiac location and the lack of attachment to another rib or to a vertebra were unusual features. This anomaly is represented by the term ‘congenitally floating intrathoracic rib’. Knowing the distinct radiological features of this entity should help avoid misdiagnosis and unnecessary investigation. [Copyright &y& Elsevier]

The article presents a case study of a 25-year-old male with recurrent right-sided chest pain and breathlessness on exertion for over a month. His second rib appeared thickened and a slight fullness in the second inter-costal space. There was no history of cough, malaise or fever. The article discusses osteochondromas, a developmental physical growth defects, cartilage capped outgrowths of bone wherein the growth stops at skeletal maturity.

The article discusses and presents the clinical image of a newborn boy who was admitted having neonatal clavicle dislocation. The patient underwent a chest radiograph showed no sings of lung disease, but did show left clavicle dislocation. It notes that the findings were accentuated by slight rotation of the chest as evidenced by the asymmetric appearance of the ribs. It states that neonatal sternoclavicular dislocation is a very rare finding and is usually a complication of delivery.

Abstract: An 11-year-old girl with an asymmetric chest wall deformity demonstrated an excavation in the flank combined with partial synergy of costae 4 and 5. She was treated by an innovative partial chest wall reconstruction consisting of rib remodeling and internal osteosynthesis. The reconstruction regained symmetry and cosmesis. Special cases of chest wall deformity require an individualized management. [Copyright &y& Elsevier]

The article focuses on the case of a male twin who was found a translucent area in the right lower zone on a background of chronic lung change from a chest x-ray. The diagnoses include extrapulmonary events or intrapulmonary pathology that lead to trace the cause which is extrathoracic. Moreover, severe chest recession has worsen on the rights side with the chest wall deformity anatomically matching the translucency on the chest x-ray. Furthermore, radiological review confirmed angulation of the lower right ribs indicating fractures and on follow-up x-ray healing fractures.