History: 50 year old man with chest pain and shortness of breath.

This is the appearance of a fused rib, or rib synostosis. Typically fused ribs are either congenitally fused or can become fused as a result of remote traumatic injury to the region of the fused ribs. Rib synostoses are relatively common, present in about 3% of the population, and they typically present with a chest wall “mass.” When congenitally fused, they can be associate with scoliosis as well as thoracic insufficiency syndrome. A retrospective review of fused ribs and chest wall anomalies and their association with congenital spine anomalies can be found here.
