Rib infarcts in sickling disease

This communication documents the radiographic appearance of multiple rib infarcts that may develop during the course of patients with sickle cell states. It can be associated with and be the cause of the 'acute chest syndrome' which has traditionally be attributed, on scanty evidence, to lung infarcts and pneumonia. Bony changes take time to develop but extrapleural changes are readily detected in radiographs. The rib lesions repair leaving residual sclerosis. Sequestra do not develop. The pathogenesis may be due to back pressure in the azygos venous system.