13 pairs of ribs and absent radius

Case contributed by Dr Naim K

Presentation

Single umbilical artery.

Patient Data

Age: 1 day
Gender: Female

CHEST X-RAY:

Prominent central vascular markings. Clear costophrenic angles.

13 pairs of ribs. 

Absent left radius. Bowed left ulna.

Normal visualized spine.

Case Discussion

First day of life, baby girl after uncomplicated normal vaginal delivery with a single umbilical artery. Present with respiratory distress, cyanosis, and limb deformity. An initial x-ray (image above) was done. On the same day, she was admitted to NICU for umbilical venous catheter insertion. Three days later abdomen and pelvis ultrasound was requested to evaluate for other anomalies however the examination was normal.

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