Supernumerary ribs

Case contributed by Claire Isidro
Diagnosis certain


Concern for spinal curvature on clinical exam

Patient Data

Age: 15 years
Gender: Female
  • mild dextroconvex thoracic curvature. No vertebral anomaly.
  • please note there are 13 pairs of ribs and 5 non-rib-bearing lumbar segments. 
  • the bone density is normal. No discrete focal osseous lesion.
  • also note external artifact of hair on xray 

Case Discussion

Supernumerary ribs also called accessory ribs are an uncommon variant of extra ribs arising most commonly from the cervical or lumbar vertebrae. They occur in 0.5% to 1% of the general population and are typically bilateral. Normal is 12 thoracic (rib bearing) and five lumbar (non-bearing) ribs.  

Patients are often asymptomatic. Accessory ribs are often discovered incidentally via radiography. In some cases, patients may have localized pain or symptoms from compression of nearby structures. Related pathology includes thoracic outlet syndrome with compression of the brachial plexus. 

Increased numbers of ribs may be associated with conditions such as Turner Syndrome, Trisomy 8, Cleidocranial Dysplasia and others.

This case was submitted with supervision and input from:

Soni C Chawla, M.D.
Associate Professor
Department of Radiological Sciences
David Geffen School of Medicine at UCLA
Olive View - UCLA Medical Center

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