A 4-year-old girl was referred to Tygerberg Academic Hospital with a long-standing history of an asymptomatic anterior chest wall ‘lump'. On physical examination, a bony mass was palpated in relation to the anterior aspect of the left 4th rib. Plain radiography demonstrated anterior widening of the left 4th rib. Fearing a sinister cause, a multidetector computed tomography (MDCT) examination of the chest, with 3D reconstruction and volume rendering, was performed. A congenital bifid left 4th rib was demonstrated.
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