Abnormal Rib Cage at Birth: Clinical Context and Terminology

Specific Terminology Based on Clinical Presentation

The American Academy of Pediatrics notes that "rachitic rosary" refers to prominent knobs of bone at the costochondral joints in patients with rickets, also known as beading of the ribs, creating the appearance of large beads under the skin of the rib cage 1, 2
The American Academy of Pediatrics also notes that "Harrison's groove" is a horizontal groove along the lower border of the thorax corresponding to the costal insertion of the diaphragm, appearing in rickets due to defective mineralization where the diaphragm pulls the softened bone inward 1, 2

The American College of Obstetricians and Gynecologists recommends that "abnormal chest or ribs" is the general descriptive term used when skeletal dysplasias are detected prenatally, often accompanied by shortened or bowed limbs and undermineralized skull 3

The American Thoracic Society notes that at birth, the ribs extend almost at right angles from the vertebral column, making the rib cage more circular than in adults and lacking mechanical efficiency 4, 5, 6
The American Thoracic Society also notes that the ribs are already elevated at birth, which is why rib cage motion contributes little to tidal volume in infants 4, 5, 6
Progressive mineralization of the ribs occurs concurrently with the infant assuming upright posture, with rib cage contribution to breathing reaching adult-like values between 1 and 2 years of age, as stated by the American Thoracic Society 4, 5, 6

The American College of Obstetricians and Gynecologists recommends that the term used should reflect the specific underlying pathology rather than just describing the appearance, as this guides prognosis and management 3
Genetic testing and expert consultation are essential when skeletal dysplasia is suspected, as interpretation requires correlation with clinical findings, according to the American College of Obstetricians and Gynecologists 3