Bifid Rib: Anatomical Considerations in Three Cases

ABSTRACT

The present study involved a detailed investigation of 3 cases of bifid rib, focusing on anatomical features, and classified them into 2 types. The bifid ribs were in the right fourth rib of all 3 male cadavers. The upper intercostal spaces of the fourth bifid rib were considerably narrowed, whereas the lower intercostal spaces were widened. Although the size and shape of the bifid space between the upper and lower divisions of the bifid rib were different, the intercostal muscles were present in the bifid space in all cases. The third anterior intercostal artery from the internal thoracic artery supplied the bifid space in all cases. In 2 cases, the fourth intercostal nerve ran along the inferior margin of the fourth bifid rib and innervated the muscles of the bifid space. In the third case, there was another branch from the third intercostal nerve supplying the muscles of the bifid space as well as the fourth intercostal nerve. The bifid ribs are associated with other diseases or develop accidentally or sporadically. Knowledge of this malformation is needed for the differential diagnosis with other diseases, such as a chest wall tumor or costal fracture.