Fusion of the rib on plain chest radiography: a real or false image?

Fig. 2 Conflict interest statement The authors declare that they have no conflict of interest to the publication of this article. There are many types of congenital anomalies and deformities of the ribs, including developmental fusion of two or more ribs, articulation or bridge formation between two ribs, and bifid rib. These morphological anomalies and anatomical variants occur in 0.15%–0.31% of the population, are more common in females, and occur more frequently on the right side than on the left side. These anomalies are usually of little or no clinical significance [1]. A 23-year-old man presented to our radiology department for a chest plain radiography as part of a routine test. He had no complaints and a normal medical history. On the plain radiography, it appeared that he had a bony fusion between the fifth and the sixth right anterior ribs (Fig. 1). On a volume rendering three-dimensional computed tomography (3D-CT) scan, the rib cage seemed normal (Fig. 2). There were no anomalies detected in the 3D-CT images. If there were an anomaly seen with the plain radiography, this may have been an artifact as opposed to a real image. Thus, we should always base our diagnoses on more than one image and should examine both plain radiography and CT.