Rib Notching

RIB NOTCHING

Q. 1

Following can cause rib notching except:

 A

Blalock Taussig shunt

 B

Waterston Cooley’s shunt

 C

Pulmonary atresia with large VSD

 D

All

Q. 1

Following can cause rib notching except:

 A

Blalock Taussig shunt

 B

Waterston Cooley’s shunt

 C

Pulmonary atresia with large VSD

 D

All

Ans. B

Explanation:

B i.e. Waterston Cooley’s shunt


Q. 2

Superior rib notching is/are caused by:

 A

Hyperparathyroidism

 B

Poliomyelitis

 C

Marfan syndrome

 D

All

Q. 2

Superior rib notching is/are caused by:

 A

Hyperparathyroidism

 B

Poliomyelitis

 C

Marfan syndrome

 D

All

Ans. D

Explanation:

A, B, C, i.e. Hyperparathyroidism, Poliomyelitis, Marfan syndome


Q. 3

Rib notching is found in :

 A

Neurofibromatosis

 B

Lymphangiomyomatosis

 C

Aortic aneurysm

 D

a and c

Q. 3

Rib notching is found in :

 A

Neurofibromatosis

 B

Lymphangiomyomatosis

 C

Aortic aneurysm

 D

a and c

Ans. D

Explanation:

A i.e. Neurofibromatosis; C i.e. Aortic aneurysm


Q. 4

Inferior rib notching is seen in

 A

Coarctation of aorta

 B

Rickets

 C

ASD

 D

Multiple myeloma

Q. 4

Inferior rib notching is seen in

 A

Coarctation of aorta

 B

Rickets

 C

ASD

 D

Multiple myeloma

Ans. A

Explanation:

A i.e. Coarctation of aorta 

Inferior rib notching in coarctation of aorta is d/t pressure erosion of intercostal arteriesQ It usually takes several years to develop, so is unusual before 10 years of age.

Quiz In Between


Q. 5

Inferior Rib notching is seen in all except‑

 A

Coarctation of aorta

 B

Classical blalock tausing operation

 C

SVC obstruction

 D

Neurofibromatosis

Q. 5

Inferior Rib notching is seen in all except‑

 A

Coarctation of aorta

 B

Classical blalock tausing operation

 C

SVC obstruction

 D

Neurofibromatosis

Ans. D

Explanation:

Answer is D (Neurofibromatosis)

Neurofibromatosis is associated with superior rib notching

Inferior rib notching is characteristically seen in coarctation of Aorta and may also be seen in Superior vena cava obstruction and a Blalock-Taussig shunt operation

Rib-Signs in Coarctation of aorta:

  • Inferior rib notching is characteristic, and is believed to be due to pressure erosion by intercostal arteries.
  • Inferior rib notching takes several years to develop and is rarely seen before the age of 8 years.e
  • ‘3’ signemay be seen due to enlargement of left subclavian artery above the coarctation
  • Usually spares fist two ribse where intercostal arteries arise from costocervical trunk which is proximal to the usual site of CA. Mostly commonly affected ribs are the 4th to 8th ribs.
  • Usually bilateral but asymmetrical.

Q. 6

Rib notching is a feature of:

September 2006

 A

ASD

 B

PDA

 C

Coarctaation of aorta

 D

All of the above

Q. 6

Rib notching is a feature of:

September 2006

 A

ASD

 B

PDA

 C

Coarctaation of aorta

 D

All of the above

Ans. C

Explanation:

Ans. C: Coarctaation of Aorta

Radiological sign of coarctation of aorta:

Rib Notching

  • Single best sign
  • Older the person, more likely to have rib notching
  • Majority have it over 20 years of age
  • Rib notching occurs in the high pressure circuit
  • Most often involves 4th-8th rib
  • Sometimes may involve 3rd and 9th
  • Does not involve 1st and 2nd ribs
  • Intercostals come off costocervical trunk and do not supply collateral flow to descending aorta
  • 4th-8th do anastomose with internal mammary to form collaterals for descending aorta
  • Rib Notching-Unilateral

Q. 7

Among the causes of rib notching are:

 A

Coarctation of aorta

 B

Congenital interruption of aorta

 C

Chronic superior venacava obstruction

 D

All of the above

Q. 7

Among the causes of rib notching are:

 A

Coarctation of aorta

 B

Congenital interruption of aorta

 C

Chronic superior venacava obstruction

 D

All of the above

Ans. D

Explanation:

Ans. All of the above


Q. 8

Rib notching is seen in all the following except:

 A

Blalock-Taussing shunt

 B

Coarctation of the aorta

 C

TVC obstruction

 D

None

Q. 8

Rib notching is seen in all the following except:

 A

Blalock-Taussing shunt

 B

Coarctation of the aorta

 C

TVC obstruction

 D

None

Ans. D

Explanation:

Ans. None

Quiz In Between



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