Bifid rib

Last revised by Yuranga Weerakkody on 17 Jun 2022

A bifid or forked or bifurcated rib is a congenital skeletal abnormality of the rib cage with the cleaved sternal end into two. They are thought to occur in ~0.2% of the population and there may be a female as well as right-sided predilection 2.

Epidemiology

Associations

Bifid ribs can be seen in Gorlin (nevoid basal cell carcinoma) syndrome.

Forked ribs can also be seen with truncus arteriosus and tetralogy of Fallot.

Clinical presentation

Usually asymptomatic, they may cause musculoskeletal pain or intercostal nerve entrapment. A bifid first rib can be an uncommon cause of thoracic outlet syndrome.

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