title: Prevalence of rib anomalies in normal Caucasian children and childhood cancer patients.
abstract: OBJECTIVE
  To evaluate the prevalence of abnormalities of rib development in normal Caucasian children and patients with childhood cancer.
  
  
  METHODS
  Chest radiographs of 881 Caucasian pediatric controls and 906 childhood cancer patients were reviewed, and independently scored by four blinded observers, using strict definitions. Prevalences of 6 major rib anomaly categories in controls were compared to their prevalence in the total group of childhood cancer patients, and the 12 individual larger tumor groups using Chi-square tests.
  
  
  RESULTS
  Values in the control population were generated for the occurrence of six major rib anomaly categories; cervical rib anomalies were present in 6.1% of controls, aplasia of 12th ribs in 6.6%, lumbar ribs in 0.9%, bifurcations in 0.7%, synostosis-bridging in 0.3%, and segmentations were not found. The overall prevalence of total rib anomalies in cases and controls was equal (14.9% and 14.2%, respectively). Cervical rib anomalies were found significantly more often in cases (8.6%) compared to controls (p-value=0.047), three groups accounting for this higher prevalence: 12.1% of acute lymphoblastic leukemia patients (p=0.011), 18.2% of astrocytoma patients (p=0.023), and 14.7% of germ cell tumor patients (p=0.046) had a cervical rib anomaly.
  
  
  CONCLUSIONS
  Prevalence figures for the presence and type of rib anomalies in a large group of normal Caucasian children were generated. In childhood cancer patients a significantly higher prevalence of cervical rib anomalies was demonstrated in patients with acute lymphoblastic leukemia, astrocytoma, and germ cell tumors.
authors.affiliation: Department of Pediatric Oncology, Emma Children's Hospital, Academic Medical Center, Amsterdam, The Netherlands. j.h.merks@amc.uva.nl
authors.forename: Johannes H M
authors.initials: JH
authors.lastname: Merks
authors.forename: Anne M
authors.initials: AM
authors.lastname: Smets
authors.forename: Rick R
authors.initials: RR
authors.lastname: Van Rijn
authors.forename: Jasmijn
authors.initials: J
authors.lastname: Kobes
authors.forename: Huib N
authors.initials: HN
authors.lastname: Caron
authors.forename: Mario
authors.initials: M
authors.lastname: Maas
authors.forename: Raoul C M
authors.initials: RC
authors.lastname: Hennekam
mesh_terms: D000293:Adolescent; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D000013:Congenital Abnormalities / Q000235:genetics / Q000473:pathology; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D009369:Neoplasms / Q000235:genetics / Q000473:pathology*; D011859:Radiography; D012272:Ribs / Q000002:abnormalities* / Q000000981:diagnostic imaging; D044465:White People