Anat Cell Biol.  2017 Jun;50(2):155-158. 10.5115/acb.2017.50.2.155.

Supernumerary lumbar ribs: a rare occurrence on an adult African male skeleton

• Chengetanai S
• Nchabeleng EK
• Bacci N
• Billings B
• Mazengenya P

• KMID: 2451242
• DOI: http://doi.org/10.5115/acb.2017.50.2.155

Abstract

Supernumerary lumbar ribs are usually asymptomatic and discovered incidentally during routine diagnostic radiography. During a routine inventory of the research skeletal repository at the University of the Witwatersrand, a rare case of bilateral supernumerary ribs on the first lumbar vertebra was observed. The skeletal specimen belonged to a 70-year-old African male whose recorded cause of death was esophageal carcinoma. Plain radiography revealed bilateral joint cavities between the transverse processes of the first lumbar vertebra and the supernumerary ribs. Clinically, supernumerary lumbar ribs may present with pain of the renal angle, cause confusion during enumeration of the vertebral levels on radiographs, and may be misinterpreted as fractures, kissing osteophytes, and/or calcification of abdominal vasculature.

Keyword

Supernumerary lumbar rib; Fracture; Transverse process; Renal angle; Lumbar vertebra

MeSH Terms

Adult*
Aged
Cause of Death
Humans
Joints
Male*
Osteophyte
Radiography
Ribs*
Skeleton*
Spine

Figure

• 

  Fig. 1 The photograph shows the bilateral supernumerary lumbar ribs. (A) A superior view of the L1 vertebra. (B) An inferior view of L1 vertebra. (C) An anterior view of L1 vertebra. (D) A posterior view of L1 vertebra.

• 

  Fig. 2 The radiographic images of the L1 vertebra showing the bilateral joint cavities between the transverse processes and the supernumerary ribs. (A) A superior view of the L1 vertebra; arrows showing the joint cavities. (B) The inferior view of the L1; the arrow shows the joint cavity.

Reference

1. Rashid M, Khalid M, Malik N. Sacral rib: a rare congenital anomaly. Acta Orthop Belg. 2008; 74:429–431.

2. Aly I, Chapman JR, Oskouian RJ, Loukas M, Tubbs RS. Lumbar ribs: a comprehensive review. Childs Nerv Syst. 2016; 32:781–785.

3. Sujatha K, Dhamodaran K. A case report of bilateral lumbar ribs. Stanley Med J. 2016; 3:94–95.

4. Chernoff N, Rogers JM. Supernumerary ribs in developmental toxicity bioassays and in human populations: incidence and biological significance. J Toxicol Environ Health B Crit Rev. 2004; 7:437–449.

5. Abdollahifar MA, Abdi S, Bayat M, Masteri Farahani R, Abbaszadeh HA. Recognition of a rare intrathoracic rib with computed tomography: a case report. Anat Cell Biol. 2017; 50:73–75.

6. Cumming J. Lumbar rib of unrecorded type. Br Med J. 1926; 1:55.

7. Anap D, Kachewar S, Prabhakar A, Diwate A, Ganvir SD. Lumbar rib: an uncommon causation of a common manifestation. Rom J Phys Ther. 2013; 18:19–21.

8. Nichols BH, Shielett EL. A supernumerary rib and arising from the second lumbar vertebra. Am J Roentgenol. 1934; 32:196–197.

9. Branch S, Rogers JM, Brownie CF, Chernoff N. Supernumerary lumbar rib: manifestation of basic alteration in embryonic development of ribs. J Appl Toxicol. 1996; 16:115–119.

10. Lanier RR Jr. Length of first, twelfth, and accessory ribs in American Whites and Negroes: their relationship to certain vertebral variations. Am J Phys Anthropol. 1944; 2:137–146.

11. Wery N, Foulon O, Blacker A, Picard JJ, Gofflot F. Vertebral malformations induced by sodium salicylate correlate with shifts in expression domains of Hox genes. Reprod Toxicol. 2005; 20:39–45.

12. Adibatti M, Asha K. Lumbarisation of the first sacral vertebra a rare form of lumbosacral transitional vertebra. Int J Morphol. 2015; 33:48–50.

13. Noback CR, Robertson GG. Sequences of appearance of ossification centers in the human skeleton during the first five prenatal months. Am J Anat. 1951; 89:1–28.

14. Bagnall KM, Harris PF, Jones PR. A radiographic study of variations of the human fetal spine. Anat Rec. 1984; 208:265–270.

15. Steiner HA. Roentgenologic manifestations and clinical symptoms of rib abnormalities. Radiology. 1943; 40:175–178.

16. MacGibbon B, Farfan HF. A radiologic survey of various configurations of the lumbar spine. Spine (Phila Pa 1976). 1979; 4:258–266.

17. Singer KP, Breidahl PD. Accessory ossification centres at the thoracolumbar junction. Surg Radiol Anat. 1990; 12:53–58.