胸部 X 光片上经常会遇到肋骨的正常变异和异常。准确识别正常变异对于避免不必要的调查至关重要。对肋骨异常的细致评估可以为了解患者的症状提供有价值的见解，即使没有怀疑有骨质状况，肋骨异常也可以为潜在疾病提供重要线索。肋骨异常与多种病症相关，包括良性肿瘤、恶性肿瘤、感染性和炎症性病症、血管异常、代谢紊乱、非意外损伤、畸形综合征和骨发育不良。肋骨异常根据其放射学模式分为三组：局灶性、多灶性和弥漫性变化。局灶性病变进一步细分为非侵袭性病变、侵袭性病变以及感染性和炎症性疾病。放射科医生应了解儿童肋骨的个体疾病，包括其影像学表现、相关临床信息和潜在的发病机制。酌情处理鉴别诊断。由于胸部X光片在某些情况下足以进行诊断，因此作者强调采用模式识别方法进行X光片解读。然而，对于肿瘤或炎症等局灶性病变，可能需要额外的横截面成像。了解疾病特异性影像学结果有助于确定病变的性质并指导适当的治疗。 ©RSNA，2023 本文的测验问题可在补充材料中找到。

Normal variants and abnormalities of the ribs are frequently encountered on chest radiographs. Accurate identification of normal variants is crucial to avoid unnecessary investigations. A meticulous evaluation of rib abnormalities can provide valuable insights into the patient's symptoms, and even when no osseous condition is suspected, rib abnormalities may offer critical clues to underlying conditions. Rib abnormalities are associated with various conditions, including benign tumors, malignant tumors, infectious and inflammatory conditions, vascular abnormalities, metabolic disorders, nonaccidental injuries, malformation syndromes, and bone dysplasias. Abnormalities of the ribs are classified into three groups based on their radiographic patterns: focal, multifocal, and diffuse changes. Focal lesions are further subdivided into nonaggressive lesions, aggressive lesions, and infectious and inflammatory disorders. Radiologists should be aware of individual disorders of the pediatric ribs, including their imaging findings, relevant clinical information, and underlying pathogenesis. Differential diagnoses are addressed as appropriate. Since chest radiographs can suffice for diagnosis in certain cases, the authors emphasize a pattern recognition approach to radiographic interpretation. However, additional cross-sectional imaging may be necessary for focal lesions such as tumors or inflammatory conditions. Awareness of disease-specific imaging findings helps ascertain the nature of the lesion and directs appropriate management. ©RSNA, 2023 Quiz questions for this article are available in the supplemental material.