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Cervical ribs: a common variant overlooked in CT imaging
V G Viertel1, J Intrapiromkul, F Maluf
1The Russell H. Morgan Department of Radiology and Radiological Sciences, The Johns Hopkins Medical Institutions, Baltimore, MD 21287, USA.
Cervical ribs are present in 2.0% of the population and are often underreported on cervical spine CT scans. Increased vigilance is needed to identify these congenital variants and their potential clinical implications.
Area of Science:
- Radiology
- Anatomy
- Medical Imaging
Background:
- Cervical ribs are congenital anatomical variations.
- They can lead to thoracic outlet syndrome (TOS) or brachial plexopathy in up to 10% of individuals.
- Detection can be challenging due to their subtle nature.
Purpose of the Study:
- To determine the incidence of cervical ribs in adults using cervical spine CT scans.
- To assess the reporting rate of identified cervical ribs by radiologists.
- To highlight the underreporting of this congenital variant.
Main Methods:
- Retrospective review of 3404 adult cervical spine CT scans and their reports.
- Analysis of the presence and laterality of cervical ribs.
- Comparison of prevalence across demographic groups and assessment of radiologist reporting.
Main Results:
- Cervical ribs were identified in 2.0% (67/3404) of patients.
- 40.3% of identified cervical ribs were bilateral.
- African Americans showed a higher prevalence (70.1%) compared to whites (26.9%).
- Radiologists reported only 25.5% of the identified cervical ribs.
Conclusions:
- The prevalence of cervical ribs is approximately 2.0% in the studied population.
- Cervical ribs are significantly underreported in cervical spine CT interpretations.
- Neuroradiologists should exercise greater diligence in identifying these variants due to their clinical significance.
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