Ribs (Human Anatomy): Image, Function, Diseases, and Treatments

The ribs are the thoracic cavity's bony framework. The ribs are the primary structural component of the thoracic cage, protecting the thoracic organs; nevertheless, their primary purpose is to help respiration. There are a total of twelve pairs of ribs.The costovertebral joint connects each rib to two thoracic vertebrae posteriorly. They are known as costal cartilage, and they articulate with the vertebral column posteriorly before ending anteriorly as cartilage.Because they are part of the bony thorax, the ribs protect the interior thoracic organs. They also contribute to the movement of ventilation that occurs as the chest extends to allow for lung inflate.Ribs are classified into two types: Atypical and Typical.

While atypical ribs exhibit variations on this structure, normal ribs have a uniform structure. All 12 pairs of ribs connect to the vertebrae of the spine posteriorly. The first seven ribs connect to the sternum independently. The eighth, ninth, and tenth ribs are connected to the costal cartilages above them, however the eleventh and twelve ribs do not have an anterior link and end in the abdominal muscle.

They are called 'floating ribs' because of this. There are two joints in each rib: the Costotransverse joint, which connects the tubercle of one rib to the transverse costal facet of the corresponding vertebra, and the Costovertebral joint, which connects the head of the rib to the superior costal facet of the corresponding vertebra and the inferior costal facet of the vertebra above it.

The rib cage is an important part of the body's respiratory system. The lungs are shielded from harm since the thoracic cavity is completely covered. Aside from serving as a shield for the internal organs and tissues of the chest, it also aids in the processes involved in breathing and respiration. Supporting the upper limbs, they also offer a point of attachment for muscles and tendons.

• Rib Fractures: These are caused by direct trauma or crushing injuries and usually affect the middle ribs. A rib fracture's broken shards might cause further soft tissue injury. The organs most vulnerable to harm include the diaphragm, spleen, and lungs.
• Flail Chest: If two or more fractures occur in two or more neighbouring ribs, the affected region is no longer under the control of the thoracic muscles. When the lungs expand and contract, it produces a paradoxical movement. This condition is known as flail chest. It stops the ribcage from fully extending, which affects the oxygen concentration of the blood. Repairing the affected ribs eliminates the paradoxical movement that produces flail chest.
• Hypoplastic: Short ribs, often known as short ribs, are one of the least prevalent rib anomalies. If a rib's lateral border is more than 4 mm medial to a tangent made between the lateral margins of neighbouring ribs, it is called hypoplastic.
• Rib Dislocation: Rib dislocation is another term for subluxation. A displaced rib can arise from trauma, causing discomfort, difficulty moving, and breathing problems. The dislocation occurs at the facet joint, which joins your rib to your spine. As a result, your back muscles may experience cramping. Subluxation occurs when a rib moves out of place but is not totally dislocated.
• Osteoporosis: Osteoporosis is a bone weakening condition that raises the chance of rib fractures from falls.
• Tumour: These tumours can be caused by either primary or secondary lesions. An insidious onset of pain might indicate that a rib contains a benign or malignant tumour.
• Slipping Rib Syndrome: The floating ribs movement characterises the illness, commonly known as Cyriax syndrome. These lower ribs frequently make a sliding, clicking, or cracking sound when they move. Although the sensation normally only affects one side of the rib cage, it might migrate to the back on the afflicted side. The sensation might be painfully painful or simply irritating.
• Intercostal muscle strain: Intercostal muscle strain symptoms might range from acute pain to a more gradual development of discomfort. Twisting, stretching, heavy breathing, coughing, or sneezing will aggravate the discomfort. Tenderness: Where the strain lies between your ribs, you will feel tender to the touch.
• Costochondritis: Costochondritis is an inflammation that occurs in the centre of the chest where the ribs connect to the breastbone. Sharp chest pain may be felt, especially while moving or breathing. It frequently improves on its own over time..
• Lung Bruising: A pulmonary contusion or lung tissue bruise can result from chest trauma. This may cause significant chest wall discomfort similar to rib pain. Rib fracture and pulmonary contusion are also possible after chest trauma.
• Pulled muscles: Small muscles positioned between each rib have the potential to be strained or pulled. Strenuous coughing or heavy lifting can also cause muscular strain in the chest wall. Discomfort that appears to be rib pain might be caused by strained chest muscles.
• Slipped Rib Syndrome: Occurs when the cartilage in the lower ribs shifts, producing chest or upper abdominal pain. The reason is assumed to be hypermobility of the rib cartilage or ligaments, particularly in the ribs 8 to 10.
• Jeune syndrome: This illness, also known as asphyxiating thoracic dystrophy, causes considerable breathing difficulties as well as an exceptionally small chest and rib cage.
• spondylocostal dysplasia/dysostosis: Spondylocostal dysplasia/dysostosis is a rare condition that causes abnormal rib and spine development. People with this disease may also have scoliosis, which is an abnormally curved spine caused by fused or misshaped vertebrae, as well as fused or missing ribs.
• Spondylothoracic Dysplasia/dysostosis: This condition is distinguished by fused or misshaped vertebrae and ribs that are fused together near the spine. Babies born with this condition have small chests and substantial respiratory difficulties.
• Pectus Excavatum: Pectus excavatum is a sternum (breastbone) abnormality that creates a conspicuous and occasionally severe depression of the chest wall. Also used are the words 'sunken chest' and 'funnel chest.'

• X-ray: X-rays reveal bones by using very low levels of radiation. However, X-rays frequently fail to reveal recent rib fractures, especially if the bone is just slightly damaged. X-rays can also be used to diagnose a collapsed lung.
• CT Scan: A CT scan may often discover rib fractures that an X-ray would have missed. Soft tissue injuries and blood vessel damage are also more visible on CT images. This procedure use X-rays taken from various angles to create cross-sectional slices of your body's internal organs.
• MRI: This might be used to look for injuries in the organs and soft tissues near the ribs. It may also help in the detection of less evident rib fractures. An MRI uses a powerful magnet and radio waves to obtain cross-sectional images.
• Bone scan: This approach is excellent for detecting stress fractures, which occur when a bone splits due to repetitive trauma, such as strong coughing bouts. During a bone scan, a little amount of radioactive material is injected into your bloodstream. When it collects in the bones, especially where a bone is healing, a scanner may detect it.
• Radiographs: For patients with suspected ankylosing spondylitis, sacroiliac joint radiographs are frequently requested.
• PET CT Scan: This biological test allows for the assessment of the amount of tumour dissemination. It may also reveal the presence of other disorders in the body. It may also be used to compute the probability of repeat. This is done to rule out any other anomalies.

• Ravitch Procedure: The Ravitch technique is a surgical method used to treat severe pectus carinatum and excavatum. The modified Ravitch method necessitates the sternum and surrounding area being exposed, aberrant cartilages being removed, and the sternum being fixed in a more normal position using a metal bar. This metal rod is left in place for at least a year before being removed in another procedure.
• Nuss Procedure: The Nuss technique is a surgical treatment used to treat severe pectus excavatum. It is referred to as 'minimally invasive' since just a few minor incisions (cuts) are required. Although the Nuss treatment is less invasive, children will require pain medication and rest following the procedure. They will be absent from school for around three weeks.
• ICD Insertion: The chest tube is put into your skin between your ribs through a 1-inch (2.5-centimeter) incision. Then it is directed to the proper location. Following the implantation of your chest tube, you will undergo a chest x-ray to ensure that the tube is in the proper position.
• Tube Thoracostomy: The procedure of putting a hollow plastic tube between the ribs and into the chest to drain fluid or air from around the lungs is known as a chest tube thoracostomy. Tube thoracostomy is commonly utilised in medical, surgical, and critical care specialties.
• Video Assisted guided Thoracic duct ligation: This ensures that the duct is ligated at its entry point in the chest, blocking all accessory ducts that might be the cause of the chylothorax. Non-traumatic recurrent chylothorax treated with video-assisted right supradiaphragmatic thoracic duct ligation.
• Fibrinolytic treatment: Bilateral FRRS is an effective treatment for TOS. Younger patients with venous bilateral illness who are also competitive sports require careful postoperative surveillance for recurrent stenosis and thrombosis.

• Steroids for reducing inflammation of Ribs: Systemic Steroids such as prednisone, prednisolone, methylprednisolone, dexamethasone, and hydrocortisone are commonly used in the treatment of skin infections.
• Analgesics for pain in Ribs: Analgesics are medications used to relieve pain and reduce the amount of prostaglandins generated by the body. The drugs should be given no later than 48 hours after any cardiovascular event that produces discomfort at the time.
• Antibiotics for infection in Ribs: If the doctor finds that an infection is the root of the patient's problems, antibacterial medications will most likely be prescribed to treat the situation. Amoxicillin, ampicillin, and penicillin are the most often used antibiotics.
• Supplements for reducing pain in Ribs: Physicians prescribe nutritional supplements such as glucosamine and chondroitin to reduce discomfort and speed up the healing process in joints. Vitamin D and calcium supplements are prescribed based on age and a lack of the necessary ingredients for regular bone development and metabolism.
• Supplements for promotion of growth at the time of fracture of Ribs: A lack of B vitamins has been connected to the development of rib discomfort and growth retardation. Vitamin B supplements are commonly used to treat this disease.
• Antivirals for treating infection of Ribs: Ribavirin, acyclovir, ganciclovir, and foscarnet are just a few of the often recommended drugs in this family. These are the antivirals that have been used to treat ankle muscle and bone infections.
• Chemotherapeutic medicines for Ribs: Cisplatin's usage as a Chemotherapeutic agent has become one of the most well-known. Cisplatin is used to treat a variety of malignancies, including ovarian, lung, bladder, and cervical cancer.