title: Rib overgrowth may be a contributing factor for pectus excavatum: Evaluation of prepubertal patients younger than 10years old.
abstract: OBJECTIVE
  We compared the costal cartilage and rib length between prepubertal patients with symmetric pectus excavatum and age- and sex-matched controls without anterior chest wall depression to evaluate if rib overgrowth is a contributing factor for pectus excavatum
  
  
  METHODS
  The sample included 18 prepubertal patients <10years old with symmetric pectus excavatum and 18 age-and sex-matched controls without chest wall deformity. The full lengths of the fourth to sixth ribs and costal cartilage were measured using three-dimensional volume-rendered computed tomography and curved multiplanar reformatting techniques. The rib and costal cartilage lengths, total combined rib and costal cartilage length, and costal index ([length of cartilage/length of rib]×100 [%]) at the fourth to sixth levels were compared between the groups.
  
  
  RESULTS
  The rib lengths in the patient group were significantly longer than in the control group for the 6th right rib and 4th, 5th, and 6th left ribs. The costal cartilage lengths and costal indices were not different between two groups.
  
  
  CONCLUSIONS
  In patients with symmetric pectus excavatum aged <10years old, several of the ribs were longer than those of controls, suggesting that abnormal rib overgrowth may be a contributing factor responsible for pectus excavatum rather than cartilage overgrowth.
authors.affiliation: Department of Radiology and the Research Institute of Radiological Science, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea.
authors.forename: Chul Hwan
authors.initials: CH
authors.lastname: Park
authors.affiliation: Department of Radiology and the Research Institute of Radiological Science, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea.
authors.forename: Tae Hoon
authors.initials: TH
authors.lastname: Kim
authors.affiliation: Department of Thoracic and Cardiovascular Surgery, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea.
authors.forename: Seok Jin
authors.initials: SJ
authors.lastname: Haam
authors.affiliation: Department of Thoracic and Cardiovascular Surgery, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea. Electronic address: chestlee@yuhs.ac.
authors.forename: Sungsoo
authors.initials: S
authors.lastname: Lee
mesh_terms: D002357:Cartilage Diseases / Q000000981:diagnostic imaging; D016022:Case-Control Studies; D002648:Child; D066186:Costal Cartilage / Q000000981:diagnostic imaging / Q000254:growth & development*; D005260:Female; D005660:Funnel Chest / Q000000981:diagnostic imaging / Q000209:etiology*; D006801:Humans; D006984:Hypertrophy; D008297:Male; D009929:Organ Size; D012189:Retrospective Studies; D012272:Ribs / Q000000981:diagnostic imaging / Q000254:growth & development*; D018709:Statistics, Nonparametric; D035441:Thoracic Wall / Q000000981:diagnostic imaging; D014057:Tomography, X-Ray Computed
keywords: Costal cartilage; Pectus excavatum; Rib; Three-dimensional computed tomography