Quantitative geometric analysis of rib, costal cartilage and sternum from childhood to teenagehood

Abstract

Better understanding of the effects of growth on children’s bones and cartilage is necessary for clinical and biomechanical purposes. The aim of this study is to define the 3D geometry of children’s rib cages: including sternum, ribs and costal cartilage. Three-dimensional reconstructions of 960 ribs, 518 costal cartilages and 113 sternebrae were performed on thoracic CT-scans of 48 children, aged four months to 15 years. The geometry of the sternum was detailed and nine parameters were used to describe the ribs and rib cages. A "costal index" was defined as the ratio between cartilage length and whole rib length to evaluate the cartilage ratio for each rib level. For all children, the costal index decreased from rib level one to three and increased from level three to seven. For all levels, the cartilage accounted for 45 to 60% of the rib length, and was longer for the first years of life. The mean costal index decreased by 21% for subjects over three years old compared to those under three (p<10-4). The volume of the sternebrae was found to be highly age dependent. Such data could be useful to define the standard geometry of the paediatric thorax and help to detect clinical abnormalities.