Presentation
Medical fitness for job recruitment
Patient Data
Bifurcation of left 3rd rib at lateral angle.
Narrowing of left 3rd intercostal space posteriorly, and widening anteriorly.
Case Discussion
The apparent widening of the anterior part of the left 3rd intercostal space is due to the wide angle of bifurcation. This creates an unprotected area in the left anterior chest wall, and may be at increased risk of vital organ injury by external agents. It may also be a predisposing factor for intercostal herniation of lung.
Such configuration may also be associated with abnormal attachment pattern of intercostal muscles, which may hamper or reduce lung expansion in this part. This would allow localized accumulation of lung secretions, which may predispose to recurrent lung infections.
Other than the above factors, rib bifurcation is an anatomic variant with little clinical implication.