CT diagnosis of rib anomalies, tumors, and infection in children

The computed tomography (CT) findings of 3 patients with Ewing's sarcoma and 10 patients with a variety of benign rib lesions including osteomyelitis, hemangiomatosis, eosinophilic granuloma, aneurysmal bone cyst, neurofibromatosis, enchondroma, and Jarcho-Levin syndrome are presented. CT is of great value in demonstrating characteristic findings of several benign rib lesions. Also, CT accurately shows the destructive pattern of the rib lesion, the presence of pleural effusion, and the local spread of the soft tissue mass. When an aggressive rib lesion with pleural effusion is encountered in an infant or child, Ewing's sarcoma must be excluded unless this lesion has characteristic radiographic findings and a strong clinical history that suggest another diagnosis. The CT findings and differential diagnosis of rib lesions are discussed. Three-dimensional CT well demonstrated the appearance of congenital rib anomalies.