• Journal of Korean Orthopaedic Sports Medicine
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• v.7 no.1
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• pp.50-54
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• 2008

Purpose: In most cases, the main cause of chest or back pain during playing golf is rib fractures. This kind of rib fractures can be easily overlooked in plain radiographs. The purpose of this article is to clarify the value of the ultrasound in detecting rib fractures. Materials and Methods: We compared the findings of chest-X rays (anteroposterior, left or right lateral, both oblique view) with those of the ultrasound in 56 patients between the ages of 20th & 60th who were diagnosed rib fractures. Their chief complaints were chest or back pain which developed during playing golf. The results were analyzed statistically. Results: Among 56 cases of rib fractures, 34 cases were diagnosed with initial X-rays. 51 cases were diagnosed with ultrasound. The sensitivity of radiograph and ultrasound were 60.71% & 91.07%, respectively. Dignosis was ultrasound with statical significance whereas radiography did not(p=0.0004). Conclusion: It was concluded that ultrasound is a valuable tool in the diagnosis of the rib fractures which were undetected with X-rays during playing golf.

• Journal of the Korean Society of Radiology
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• v.12 no.4
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• pp.525-532
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• 2018

This study is filmed by applying the axial angle variation of the X-ray tube instead of the patient's position change during the perimetric examination of the ribs. A Reference image with the rib oblique examination using a chest phantom and experimental images applied with a six-phase variation in the axial angle by increasing $5^{\circ}$ tube angle each from $5^{\circ}{\sim}30^{\circ}$ from the vertical incident direction of the chest phantom to the right horizontal axis were obtained. For the quantitative comparative evaluation of the images, SNR and CNR were calculated for regions of interest in the experimental images based on the reference image. Also, the left-right rib ratio in the reference image and the left-right rib ratio in the experimental images are measured and compared. As a result of the study, the experimental images with a tube angle of $25^{\circ}$ were best shown in the measurements of the SNR, CNR and left-right rib ratio compared to the reference image with a standard examination method. The modified rib examinations will consider useful, if it is difficult to maintain the patient's examination position.

• Journal of the Korean Society of Radiology
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• v.5 no.5
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• pp.255-260
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• 2011

We wanted to evaluate the usefulness of three-dimensional reconstructive images using computed tomography for rib fracture patients. The reconstruction used in clinical multi planar reformation(MPR), volume rendering technique(VRT), and image data using quantitative methods and qualitative methods were compared. Much more, the artifact shadow was minimized to reconstruct with 3D volumetric image by using an law data in the analysis of the reconstructive image and chest CT scan of the evaluation result fractures of the thoracic patient. And we could know that the fractures of the thoracic determination and three dimension volume image reconstruction time were reduced.

• Nuclear Medicine and Molecular Imaging
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• v.43 no.4
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• pp.287-293
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• 2009

Purpose: This study is to evaluate rib fractures on bone scan in breast cancer patients treated with breast cancer surgery and radiation therapy and to evaluate its relation with radiation therapy and operation modality. Materials and Methods: Two hundred seventy cases that underwent serial bone scan after breast cancer surgery and radiation therapy were enrolled. Bone scan and chest a findings of rib fracture were analyzed. Results: The rib uptake was seen in 74 of 270 cases (27.4%) on bone scan and 50 cases (18.5%) were confirmed to have rib fracture by chest CT. The rate of modified radical mastectomy in patients with rib fracture was significantly higher than that in patients without rib fracture (66.0% vs. 27.0%, p = 0.000). The rate of additional radiation therapy to axillar or supraclavicular regions in patients with rib fracture was significantly higher than that in patients without rib fracture (62.0% vs. 28.6%, p =0.000). Rib fracture was seen most frequently at 1-2 years after radiation therapy (51.9%) and single rib fracture was seen most frequently (55.2%). Of total 106 rib fractures, focal rib uptake was seen in 94 ribs (88.7%) and diffuse rib uptake was seen in 12 ribs (11.3%). On one year follow-up bone scan, complete resolution of rib uptake was seen in 15 ribs (14.2%). On chest a, the rate of fracture line in ribs with intense uptake was significantly higher than that in ribs with mild or moderate uptake (p = 0.000). The rate of presence of fracture line in ribs with focal uptake was significantly higher than that in ribs with diffuse uptake (p = 0.001). Conclusion: Rib fracture in breast cancer patients after radiation therapy was related to radiation portal and operation modality. It should be interpreted carefully as a differential diagnosis of bone metastasis.

• Journal of radiological science and technology
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• v.41 no.5
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• pp.391-396
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• 2018

The purpose of this study was to compare and analyze the patient dose according to the distance between the X-ray tube focus and the image receptor, and to propose a new method for quantitatively evaluating the image quality. Using this quantitative evaluation method, the optimal distance for increasing x-ray image quality with low radiation dose was estimated between source and image receptor in Rib series radiography. Phantom images were obtained by changing the distance between focus and image receptor (100 cm and 180 cm). The patient radiation dose was estimated using entrance surface dose and dose area product. In order to evaluate image quality objectively, a non - reference image evaluation method was employed with paper and salt noise and Gaussian filter. As a result of this study, when the SID was changed from 100 cm to 180 cm, the entrance surface dose decreased by 4 ~ 5 times and the dose area product decreased by 3 times. In addition, there is no significant difference in image quality between of SID 180 cm and SID 100 cm. In conclusion, it was demonstrated that performing the rib series radiography at SID 180 cm is an optimal method to reduce the exposure dose and improve the image quality.

• The Journal of the Korean bone and joint tumor society
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• v.12 no.2
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• pp.103-111
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• 2006

Purpose: Sternocostoclavicular hyperostosis (SCCH) is a disease of unknown etiology, which is characterized by periosteal reaction and endosteal hyperossification of the sternum, clavicles and upper ribs as well as ossification of the surrounding soft tissue. SCCH is a well recognized but uncommon condition which is important differential diagnosis to consider to avoid misdiagnosis and to differentiate the condition from malignant process. But few studies have reported long-term clinical result of SCCH. We report long-term clinical result of SCCH. Materials and Methods: From 1986 to 2000, 17 cases of SCCH were followed up over two to 14 years. We evaluated the radiologic, pathologic and clinical results. Results: Four men and thirteen women were studied. The age when first symptom appeared were raged from17 to 60(average-48.7) There are no specific bacteriological, serological or histological finding. Usually a permanent increase in the erythrocyte sedimentation rate is found. The radiological examination showed the signs of proliferate destructive arthritis in most case. The majority of patients respond to NSAIDs and antibiotics. Conclusion: Sternocostoclavicular hyperostosis is uncommon benign condition, but important condition in the differential diagnosis of inflammatory or malignant process of this joint.

• Journal of Chest Surgery
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• v.38 no.11 s.256
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• pp.788-790
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• 2005

Chondromyxoid fbroma (CMF) is a rare, benign tumor of the bone that represents fewer than $2\%$ of all benign tumors of bone. CMF is most often found in the long tubular bones, especially the tibia and femur near the knee joint. Less common sites included the pelvis, fibula, calcaneus and rib. A 54-year-old male patient presented to us with history of swelling and mild, intermittent local pain without any rise in overlying skin temperature in lateral portion of left 7th rib for one-month duration, which was diagnosed as benign rib tumor by plain chest X-ray and CT scan, and treated successfully by excision of rib with good result. Pathologic diagnosis of this tumor was CMF. Without any medical therapy, there was no evidence of recurrence after operation. We report this case and follow-up of the patient.

• The Journal of the Korean bone and joint tumor society
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• v.6 no.4
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• pp.163-167
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• 2000

Aneurysmal bone cyst(ABC) is a benign lesion and generally occurs in the long bones and vertebral column. ABC of the rib is an uncommon entity. We reported a case of ABC originating in the left first rib. The patient was a 19-year-old woman and presented with palpable mass on the shoulder. Chest X ray and MRI showed a large expansile mass, with multiple cystic areas, arising from the left first rib and bulging out into retroclavicular and paravertebral soft tissue, so the lesion was initially misdiagnosed as a soft tissue malignant tumor destructing adjacent rib. On histological examination, the mass, which was surrounded by a peripheral band of mature trabecular bone, consisted of multiple anastomosing cavernous blood channels separated by fibrous septa that containing osteoid, myxochondroid material and osteoclast-type giant cells.

• Journal of Chest Surgery
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• v.42 no.2
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• pp.268-271
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• 2009

Solitary plasmacytoma of bone is a rare disease that accounts for only about $3{\sim}5%$ of all plasma cell tumors. Especially, no case of solitary plasmacytoma of a rib origin has been described in the Korean literature. A 54 year old Korean man was referred to our hospital for further evaluation of a lung mass that had been detected on a screening chest radiograph. A tumor with a left 6th rib origin was revealed by the computed tomography(CT) and positive emission tomography (PET-CT); therefore, surgical resection was performed. The histopathological findings of the tumor revealed plasmacytoma of a rib origin. The postoperative screening test revealed no evidence of multiple myeloma. Postoperative radiation therapy was not performed, and no new lesion has been noted during the 2 years of follow up.

• Journal of Chest Surgery
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• v.42 no.4
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• pp.502-508
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• 2009

Background: Rib fractures are the most common injuries that are caused by blunt chest trauma. However, fractures of the costal cartilage generally go unnoticed on chest X-rays unless they involve a calcified cartilage. For this reason, the sensitivity of conventional radiography for detecting rib fractures is low, and especially those involving the cartilaginous part of the rib. Thus, we have evaluated the usefulness of ultrasonography for detecting fractures of the costal cartilage that were overlooked on the conventional radiographs of patients who suffered minor blunt chest traumas. Material and Method: A total of 45 patients who suffered minor blunt chest trauma and who had no evidence of rib fractures or other major fractures on conventional radiographs were admitted for ultrasonography between April 2008 and March 2009. There were 24 women and 21 men, and the mean age of the patients was 50.4$\pm$15.91 years (range: 17$\sim$76 years). They were examined for the detection of fractures of the costal cartilage by performing ultrasonography with a 7.5-MHz linear transducer. Result: A total of 30 patients (67%) had fractures of the costal cartilage, whereas 15 patients (33%) had no evidence of chondral rib fractures. The mean number of fracture sites of the fractured costal cartilage was 1.6$\pm$0.81 (range: 1$\sim$4 sites) in 30 patients. Periosteal hematoma was the most common finding associated with fractures of the costal cartilage (n=7, 17%), followed by sternum fracture (n=5, 12%). However, periosteal hematoma was noticed in 1 patient (2%) who was without fracture of the costal cartilage, and sternum fracture was noticed in 1 patient (2%) who was without fractures of the costal cartilage. Conclusion: The results of this study suggest that ultrasonography may be a useful imaging modality for detecting fractures of the costal cartilage that are overlooked on the conventional radiographs of patients who suffer minor blunt chest trauma.