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Case report
Submitted: 2023-05-25
Accepted: 2023-07-05
Published online: 2023-08-04
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Rare discovery of sacral “ribs”: a cadaveric case report

Jonathan A. Millard1, Kaivon Kouhestani1, Ahmed Qizilbash1, Christine Mayuga1, Casey Moore1, Kim A. Nguyen2, Paul Anthony Carpio1, Rachel E. Haley1
Affiliations
  1. Edward Via College of Osteopathic Medicine, Blacksburg, Virginia, United States
  2. United States

open access

Ahead of Print
CASE REPORTS
Submitted: 2023-05-25
Accepted: 2023-07-05
Published online: 2023-08-04

Abstract

Supernumerary ribs are a well-documented congenital anomaly that can occur at any point of the vertebral column, most commonly in the cervical or lumbar region. However, accessory ribs found in the sacrococcygeal region are exceptionally rare and may be difficult to distinguish from other bony manifestations of the pelvic girdle. During cadaveric dissection, a pair of sacral “ribs” were found projecting from the left posterolateral sacral region. The bony projections shared a broad base from the posterior sacrum. The projections followed an anteroinferior trajectory, mimicking the thoracic rib structure. Computed tomography (CT) revealed further bony anomalies, including bilateral ossifications embedded in the sacrotuberous ligament, and a blunt bony protrusion extending toward the ischial spine. Most documented supernumerary ribs in the lumbar and sacrococcygeal regions are asymptomatic and are incidental findings in radiographic studies during the exploration of other medical complaints. Correlated symptoms mentioned in the literature include pelvic pain and decreased hip range of motion, with potential obstetric complications. Owing to their asymptomatic nature, sacral ribs may be underreported. The primary aim of this report is to provide a detailed description of these sacral “ribs” in the unique setting of a cadaveric dissection supplemented with medical imaging to enhance visualization.

Abstract

Supernumerary ribs are a well-documented congenital anomaly that can occur at any point of the vertebral column, most commonly in the cervical or lumbar region. However, accessory ribs found in the sacrococcygeal region are exceptionally rare and may be difficult to distinguish from other bony manifestations of the pelvic girdle. During cadaveric dissection, a pair of sacral “ribs” were found projecting from the left posterolateral sacral region. The bony projections shared a broad base from the posterior sacrum. The projections followed an anteroinferior trajectory, mimicking the thoracic rib structure. Computed tomography (CT) revealed further bony anomalies, including bilateral ossifications embedded in the sacrotuberous ligament, and a blunt bony protrusion extending toward the ischial spine. Most documented supernumerary ribs in the lumbar and sacrococcygeal regions are asymptomatic and are incidental findings in radiographic studies during the exploration of other medical complaints. Correlated symptoms mentioned in the literature include pelvic pain and decreased hip range of motion, with potential obstetric complications. Owing to their asymptomatic nature, sacral ribs may be underreported. The primary aim of this report is to provide a detailed description of these sacral “ribs” in the unique setting of a cadaveric dissection supplemented with medical imaging to enhance visualization.

Get Citation

Keywords

accessory rib, supernumerary rib, pelvic digit, iliac horns, sacral variation

About this article
Title

Rare discovery of sacral “ribs”: a cadaveric case report

Journal

Folia Morphologica

Issue

Ahead of Print

Article type

Case report

Published online

2023-08-04

Page views

287

Article views/downloads

296

DOI

10.5603/FM.a2023.0055

Pubmed

37622392

Keywords

accessory rib
supernumerary rib
pelvic digit
iliac horns
sacral variation

Authors

Jonathan A. Millard
Kaivon Kouhestani
Ahmed Qizilbash
Christine Mayuga
Casey Moore
Kim A. Nguyen
Paul Anthony Carpio
Rachel E. Haley

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