Bayramoglu Zuhal, Yilmaz Ravza, Caliskan Emine, Buyuksahin Gulsah, Bulut Furkan, Aliyev Shamil, Adaletli Ibrahim
Radiology Department, Istanbul Medical Faculty, Istanbul University, Capa, Fatih, Istanbul, 34093, Turkey.
Surg Radiol Anat. 2018 Jan;40(1):63-65. doi: 10.1007/s00276-017-1937-5. Epub 2017 Nov 3.
Although mild bone angulation with osseous enlargement often suggests fractures with callus formation, in some cases the diagnosis is synchondrosis.
We present a rare variation of the chest wall in a 15-year-old male with a history of lymphoma. Bilateral multi-level posterior rib enlargements revealing mild F-fluorodeoxyglucose uptake were detected via positron-emission tomography/computed tomography. The variations were identified as healing fractures, although the more accurate diagnosis was determined to be multi-level posterior rib synchondroses with consecutive bridgings. Although variant bone anatomies are commonly seen in radiological practice, such multiple symmetrical posterior rib synchondroses associated with consecutive bridgings and articulations have not been clearly demonstrated before.
Awareness of such a rare combination of a well-known variation is crucial for radiologists to exclude malignancies, possibility of fracture and suspicion of child abuse.
尽管伴有骨质增大的轻度骨成角常提示骨折并伴有骨痂形成，但在某些情况下诊断为软骨结合。
我们报告一名15岁有淋巴瘤病史男性患者胸壁的罕见变异情况。通过正电子发射断层扫描/计算机断层扫描检测到双侧多节段后肋增大，并显示轻度氟脱氧葡萄糖摄取。这些变异最初被诊断为愈合性骨折，但更准确的诊断为多节段后肋软骨结合并伴有连续性桥接。尽管在放射学实践中常见骨骼解剖变异，但这种伴有连续性桥接和关节的多个对称性后肋软骨结合此前尚未得到明确证实。
认识到这种已知变异的罕见组合对于放射科医生排除恶性肿瘤、骨折可能性及虐待儿童嫌疑至关重要。
