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Rib Cage: What To Know

Medically Reviewed by Poonam Sachdev on September 07, 2022

You’ve most likely heard of the rib cage. Everyone has one, but what does the rib cage do, exactly?

The rib cage is also known as the thoracic cage, and the primary rib cage function is to protect the organs inside the chest. These organs include the heart and lungs, which are two of our most important organs. 

The thoracic cage bones include more than just the ribs, though. They also include the sternum and the thoracic vertebrae, where the ribs form. 

Unfortunately, while the ribs protect the heart and lungs, they can become damaged for various reasons. 

What Is the Rib Cage?

The rib cage is part of the axial skeleton. The average human is born with the same number of ribs regardless of gender. The ribs articulate with the thoracic vertebra. For example, the first rib, or rib 1, is the most significant and corresponds to the T1 thoracic vertebrae. Rib 2 corresponds to the T2 thoracic vertebra, rib 3 corresponds to the T3 thoracic vertebrae, and so on. 

Where Is the Rib Cage?

The chest is where the rib cage is located. It surrounds the heart and lungs and is positioned posteriorly to the thoracic vertebrae. Each rib has two ends, one with various components and bumps, while the other is rounded and smooth. 

How Many Ribs Do We Have?

The average person is born with 24 ribs—12 on each side. The ribs are located in the thoracic cage and thorax, along with their costal cartilages and the sternum. Each rib is made up of a few different components: the head, the neck, the tubercle, the angle, and the body.

Rib Cage Injuries and Conditions

Rib deformities occur in some babies during childbirth or due to genetic mutations inherited from one or both parents. In some cases, these deformities may happen spontaneously. This is known as de novo gene mutations. These deformities can range in severity from mild to life-threatening. 

Some deformities can cause the lungs to constrict, which can cause difficulty breathing. Other deformities include: 

  • Extra ribs 
  • Missing ribs 
  • Short ribs
  • Abnormally shaped ribs
  • Ribs that have been fused

One condition relating to the ribs is called thoracic insufficiency syndrome. This occurs when the ribs are deformed, creating a small chest where healthy lungs cannot develop correctly.

Most of the time, these deformities happen due to genetic mutations. Sometimes these mutations happen as a result of genes passed down from the parents. Other times, these mutations occur on their own. 

Rib deformities can happen in isolated incidents or alongside other issues. For example, patients with Down syndrome are often born with extra ribs. Sometimes, patients with Down syndrome are also born with a missing pair of ribs. In these cases, it is rare for health issues to occur. 

There are also other conditions in which rib deformities appear. These include: 

  • Juene syndrome: This condition occurs when the chest and rib cage are abnormally small. As a result, severe breathing difficulties occur.
  • Spondylocostal dysplasia: This condition is rare and occurs when abnormalities in the development of the spine and ribs occur. It is common for patients with this condition to have fused or missing ribs and an abnormally curved spine.
  • Spondylothoracic dysplasia: This condition occurs when ribs are fused near the spine. In addition, vertebrae are misshapen or fused. Babies born with spondylothoracic dysplasia have small chests and severe breathing difficulties.

Diagnosing Rib Deformities 

If rib deformities are minor, they are unlikely to cause symptoms. These deformities are usually only detected during x-rays. Children with minor deformities, such as an extra or missing rib, are unlikely to have health issues. 

Symptoms of rib deformities that are more severe include: 

  • A chest that is narrow or smaller than normal 
  • A crooked chest 
  • Trouble breathing
  • A lower abdomen that expands abnormally during inhalation

Additionally, other symptoms can happen when deformities occur alongside other conditions, such as: 

  • Short height 
  • Abnormally short legs and arms
  • Shortened torso 
  • Rigid neck
  • Scoliosis
  • Extra toes or fingers 

Rib deformities can be detected during pregnancy through ultrasound imaging. If ultrasounds do not detect deformities, though, x-rays may be necessary when the child is born, mainly if symptoms such as a small chest and breathing problems occur.

Genetic testing can also be done in cases where parents are concerned about inherited conditions. 

Treating Rib Deformities 

Treatment will vary depending on the severity and type of deformity. No health issues are present in minor cases, and treatment isn’t needed. However, if the deformity causes significant health issues such as difficulty breathing or harms the development of the lungs, your child may require breathing support. This could include intubation or a tracheotomy. 

Vertical expandable prosthetic titanium rib (VEPTR) surgery may be recommended. This surgery allows your child’s rib, spine, and lungs to grow correctly and expand by implanting titanium ribs into your child’s body. This treatment will require surgical adjustment until your child’s skeletal muscles reach full maturity. Once maturity is reached, an additional surgery known as spinal fusion may be necessary.

Prognosis of Rib Deformities

The outlook varies from child to child and depends on the severity of the deformity in question. It also depends on whether other conditions or medical issues are present alongside the deformity. 

Children receiving vertical expandable prosthetic titanium ribs surgery have a generally positive outlook. The titanium ribs allow a child to form and develop good ribs, lungs, and a spine. This surgery has a 70% survival rate for children with Jeune’s syndrome. 

Other Rib Conditions 

Some other common rib conditions include:

  • Bruised or fractured ribs: Since ribs exist to protect vital organs, they often receive the brunt of impacts and are susceptible to injuries from traumatic experiences as a result. Bruised and fractured ribs can result from vehicular accidents, steep falls, and physical assaults. Even severe coughing can bruise a rib. Symptoms of an injured or fractured rib include pain in the ribs, especially when you are breathing, coughing, sneezing, or moving in specific ways.  
  • Costochondritis: Costochondritis is a condition that is commonly associated with rib pain. Costosternial joints are the joints where the ribs and breastbones meet. When these joints become inflamed, it is referred to as costochondritis. This condition can result from chest injuries, heavy lifting, exercise, and prolonged coughing and sneezing. Symptoms of costochondritis include chest pain and tenderness. 
  • Pleurisy: Two layers of tissue line your chest cavity and lungs. This tissue is known as pleura. Pleurisy occurs when these layers become inflamed, usually due to viral infections or pneumonia. As a result, the layers rub roughly against one another when you breathe or cough, causing pain. In addition, shortness of breath may occur along with pleurisy, particularly when fluid accumulates in the pleural space. 

Show Sources

SOURCES: 

Children's Hospital of Philadelphia: “Rib Deformities in Children.”

Keck Medicine of USC: “3 Reasons You Might Have Rib Cage Pain.”

Medicine LibreTexts: “The Thoracic Cage – Ribs and Sternum.”

MyHealth Alberta: “Rib cage.”

The University of Hawai'i: “The Thoracic Cage.”

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