CT observation of rib abnormalities: spectrum of findings

The CT studies in 63 patients in which rib abnormality was identified or excluded were retrospectively analyzed. The CT features were detailed and correlated with other available radiographic findings as well as clinical data. Contiguous spread of tumor to rib or metastasis to rib characteristically showed subtle or complete segmental lytic rib destruction. An accompanying extrapleural soft tissue mass was frequently seen with metastatic disease and myeloma. In nine patients CT showed rib destruction that had been obscured on chest radiography by heart, diaphragm, mass, or pleural effusion. Other imaging studies prompted consideration of neoplasm in seven patients in whom CT clearly showed benign post-traumatic or developmental lesions. Six patients had a clinically suspected chest wall mass excluded, leading to the diagnosis of Tietze syndrome. The ribs should be carefully inspected on all CT studies of the thorax and upper abdomen. Computed tomography is helpful when other imaging techniques, such as rib films or isotopic bone scans, have not resolved the question of clinically or radiographically suspected rib abnormality.