IMAGING OF THE FIRST RIBS: VARIANT ANATOMY, PATHOLOGY, CLINICAL VALUE

Abstract

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Aim. To study the features of the first ribs during digital chest X-ray screening, taking into account variant anatomy and anomalies in timely recognition and differential diagnosis of tuberculous and oncological pathologies at the level of the first sternocostal segment of the upper aperture of the thorax. Material and Methods. imaging of the first ribs of patients undergoing digital chest X-ray screening, 14 344 women and 8949 men aged 16 to 93 years (mean age 62.5±3.4 years) in Kursk during 2016- 2017. Results and Discussion. We didn’t reveal any racial-ethnic differences in results of the primary analysiswith X-ray morphometry of the first ribs. In the randomized groups we noted sexual and age-related dimorphism of the size and structure of the first ribs, predominantly asymmetric ossification of the cartilages often mimic the focus of tuberculosis and hides the lung tumor node, leading to a late misdiagnosis. Asymmetric synostosis and hypo- and aplasia dominated the spectrum of anomalies of the first ribs. The primary pathology of the first ribs is represented by dystrophic changes in the posterior segments and stress fractures in the middle segments. Conclusions. Unified methodology for interpreting digital chest X-ray images, taking into account the features of the first ribs significant improves screening in early detection of tuberculosis and lung cancer.