Abstract
Chest pain is a common clinical presentation in daily practice. Musculoskeletal origin is a rare etiology of chest pain, compared to a cardiorespiratory problem and often underrecognized. Fork-rib or bifid-rib is a rare anomaly which uncommonly present with clinical symptoms since in most cases fork-rib incidentally found during cadaveric dissection. Here we report a 27 years old man presenting with chest pain and radiographic examination showing bifid rib of the fifth left rib, without any abnormalities from physical examination and electrocardiography. The patient treated with intravenous painkiller and anticonvulsants. Fork-rib should be considered as a differential diagnosis for chest pain of musculoskeletal origin especially in young adults or chest pain precede with minor trauma.Â
Highlights
Chest pain is a common clinical presentation in daily practice
Chest pain of musculoskeletal origin can be caused by several aetiologies, i.e. costochondritis, Tietze syndrome, osteitis, fractures, strains, myofascial pain syndrome, or congenital anomalies of bones and adjacent structures
We found 3 cases reporting fork rib with chest pain as clinical manifestations, one report a 9 years old girl complaining chest pain after minor trauma, further evaluation showing fork rib in 5th right rib.[14]
Summary
Chest pain is a common clinical presentation in daily practice. Fork rib is an anatomical variation where one rib separated or bifurcated, often in anterior part of rib This anomaly can be symptomatic or asymptomatic, symptoms include anterior bulging and pain. Mr A, 27 years old visiting internal medicine outpatient clinic with chief complain of chest pain in the lateral side of the left hemithorax. This is the first onset, experienced a day before, the pain was localized with excruciating characteristic, the pain does not radiate and not alleviated by strenuous activity or respiration. Chest radiography showing branching of the anterior part of left fifth ribs
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