Rib variations are usually incidental findings on imaging studies and are rarely symptomatic. If in adequately evaluated they are easily overlooked as most of the X-ray is aimed at evaluating the lung parenchyma. Trauma related lesions might usually be misinterpreted as rib variations and sometimes rib lesions may mimic a variant of rib and radiologists should be familiar with a number of normal variants of the ribs to avoid mistaking them for an abnormality. In this article we will discuss and illustrate variety of anatomical rib variants and their incidence in this given population. Anatomical rib variants include developmental deformities, cervical rib, Bifid (forked), fused rib and hypertrophied transverse process of C7 be used. The aim of our study is to have a comprehensive evidence-based morphological assessment of normal anatomical variations of ribs and their prevalence in this population. A Retrospective study of Chest radiographs of 1000 adults who visited our hospital for a routine check-up or for various medical examinations from September 1st 2018 to September 30th 2018, were consecutively reviewed for normal variations of rib. In our study of 1000 radiographs (Male 652 and female 348), there are 10 cervical ribs, 5 bifid ribs, 16 cases of hypertrophied transverse process and 3 fused rib. Thus in conclusion, the knowledge of incidence of normal anatomical variations of ribs and their appearance in a given population is important for radiologist as it avoids any misinterpretation of these relatively normal variants and signals a possibility of neurovascular compression if clinically relevant.
Introduction Agger nasi and haller cells are few of the common anatomical variants of Paranasal Sinuses (PNS) . They can cause obstruction of osteomeatal complex and frontal recess and can cause refractive sinusitis. Also these variants can lead to complications during procedures like Functional Endoscopic Sinus Surgery (FESS). Hence, complete knowledge about these variants and imaging features help in early diagnosis and also helps in avoiding complications during surgery. Materials and Method A retrospective study of 100 patients conducted during the period from January 2021- April 2021 in Saveetha Medical College and Hospital. All the patients included in the study were referred from the department of otorhinolaryngology for Computed Tomography of PNS. All the images were individually analysed and evaluated for occurrence of Agar Nasi cells and Haller cell variants. Results Out of the study population of 100 patients, 56% of the patients were observed for Agger Nasi cells and 19% of the patients were observed for Haller cells. Conclusion Our study concludes that agger nasi and haller cells are found in a significant proportion of the study population. Hence, Identifying these anatomical variants with great accuracy will help in diagnosing and appropriate management of refractive sinusitis and also be critical in supporting surgeons in tailoring surgery for patients when done preoperatively and thereby avoid fatal complications during procedures (1).
Meningo encephalocele is a congenital anomaly and is a neural tube defect with occipital meningo encephalocele being the most common and is a result of a failure of the surface ectoderm to separate from the neuroectoderm. This condition can be identified in 1st trimester in 80% of cases and almost all by 2nd trimester. A 20-year-old third gravida was referred for antenatal Ultrasonography at five months of amenorrhoea to rule out fetal anomalies. On targeted imaging, for fetal anomalies, a defect was seen in occipital bone with herniation of posterior fossa contents with overlying meningeal covering. No other fetal anomalies were noted. A diagnosis of isolated occipital meningoencephalocele was made with additional fetal MRI correlation. The mother underwent termination of her pregnancy by Department of Obstetrics and Gynecology because of the grim fetal prognosis. The mother was advised to plan the subsequent pregnancies and was advised pre-conceptional folic acid supplementation. We present a case of isolated occipital meningoencephalocele- a rare congenital anomaly which was diagnosed prenatally in our hospital. This case provides an opportunity for identifying such neurological defects early and prompt termination of pregnancy to prevent comorbidity to mother. This study also helps to establish occipital meninigioencephalocele as an isolated clinicoradiological diagnosis and to distinguish it from syndrome associated occipital meninigioencephalocele or those associated with other neural tube defects like Chiari III malformations. It also allows us to stress once again the role of periconceptional folic acid in preventing the occurrence of neural tube defects.
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