Bifid rib

Last revised by Liz Silverstone on 9 Jan 2025

A bifid or bifurcated rib is a congenital skeletal abnormality where the affected rib has a forked sternal end. They are thought to occur in ~0.2% of the population and there may be a female and right-sided predilection 2.

It typically involves the 3rd/4th rib (incidence: 3rd/4th > 5th > 6th > 2nd) ref.

Epidemiology

Associations

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.

Cases and figures

  • Case 1: left 6th bifid rib
  • Case 2: left 4th anterior bifid rib
  • Case 3: ultrasound - bifid right 3rd rib
  • Case 4: right 5th bifid rib
  • Case 5
  • Case 6
  • Case 7
  • Case 8
  • Case 9
  • Case 10
  • Case 11
  • Case 12
  • Case 13
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