#DX SPINE CERVICAL X RAY SERIES#

Women were found to have cervical ribs more than twice as often as men, 2.8% (39/1414) versus 1.4% (28/1990). Of the 3404 studies included in this study, cervical ribs were found in 2.0% (67/3404). A separate data sheet was compiled containing all cross-sectional neuroradiology reports in the past decade, from May 31, 2001, to May 31, 2011, containing the words “cervical ribs.” Figure 1 shows an example of bilateral processes that meet these criteria for cervical ribs. The rib must not originate from the transverse process of the first thoracic vertebra, but rather the seventh cervical vertebral transverse process, which projects horizontally from the spine.Īny scan that the readers deemed to have a cervical rib was checked for accuracy by an expert reviewer with 23 years of subspecialty neuroradiology service. The cervical rib must articulate with the C7 vertebra with a well-defined joint if the rib was fused with the vertebra, it was considered an elongated transverse process. The criteria for cervical ribs were defined as in several previous studies. Five readers were trained for the project and were instructed to look exclusively for cervical ribs. If patients had repeat scans, were younger than 18 years of age, or had nondiagnostic-quality images, their corresponding examinations (1596) were eliminated from the study, yielding 3404 examinations for review. The scan parameters used were section thickness of 0.5–0.75 mm with coronal and sagittal reconstructions, by using 120 kV(peak) and 300 mAs, on a Sensation 64-detector row scanner (Siemens, Erlangen, Germany). Coronal and sagittal 3-mm reconstructions were created by the CT technicians, but because all raw data were presented, oblique off-axis images were reconstructed as needed.

Thin 0.5-mm section CT scans were acquired in all cases.

The scans originated from all patients, regardless of their presenting symptoms, who had been to the inpatient and outpatient imaging services of a major university practice. On the basis of previous experience with lumbar spine scoliosis 9 at 66.9%, we hypothesized that, when cervical ribs were present, there would be a 25% rate of underreporting by neuroradiologists.įive thousand consecutive cervical spine CT scans obtained between November 2009 and May 2011 were compiled for viewing. We hypothesized that our results would fall between the minimum (0.05%) 5 and maximum (3.0%) 6 of the previously reported prevalences on the basis of radiographic findings. This study focuses on determining the prevalence of cervical ribs by using CT, as opposed to radiographs, which have been more commonly used in the prior literature. We expected our study to show similar results. For example, Anwar et al 9 found that 66.9% of cases of adult lumbar scoliosis went unreported on lumbar spine MR imaging studies. Previous studies with similar objectives have found underreporting to be a significant problem in radiology. Periodic investigations of the reporting success of various abnormalities and normal variants ensure that radiologists are meticulous and thorough in their efforts in reading scans.

7, 8 Second, there is an apparent discrepancy in the prevalence of the variant in the literature and its rate of detection in our routine radiology practice. This study was conceived for 2 main reasons: First, cervical ribs are abnormalities that may cause an uncomfortable and often painful syndrome in humans surgery, in which the supernumerary rib is removed, is often the only relief for affected individuals. 2, 5, 6 They are associated with TOS in approximately 10% of the affected population.

#DX SPINE CERVICAL X RAY SERIES#

1, 4Ĭervical ribs are relatively common anomalies with a wide range of reported incidences (0.05%–3.0%) based on series using radiographs. 2, 3 These can be associated with stillbirths and childhood malignancies. Mutations in Hox genes have been shown to cause the development of cervical ribs from the costal or ventral processes of the primitive vertebral arches. 1 Typical development leads to 7 cervical vertebrae followed by 12 rib-bearing thoracic vertebrae. These cells form somites, which later become vertebrae postossification. The development of the spine in a fetus is based on the formation of groups of mesenchymal cells from the mesoderm on either side of the neural tube. ABBREVIATION: TOS thoracic outlet syndrome

Dx spine cervical x ray