Background: First rib cartilage undergoes age-dependent calcification, a physiological process influenced by genetic, hormonal, and biomechanical factors, which can stiffen the chest wall and predispose to pseudarthrosis. Pseudarthrosis, a false joint formation, results from mechanical stress on calcified segments and is often mistaken for fractures. This study aimed to analyze calcification patterns and pseudarthrosis prevalence in this population using CT imaging, correlating findings with age and sex. Methodology: This was a retrospective observational, cross-sectional study conducted at a tertiary care center in South Kerala. Eighty patients (160 first rib cartilages) undergoing non-traumatic CT thorax imaging were included; patients with a recent history of trauma were excluded. Images from a 128-slice MDCT scanner were analyzed. Pseudarthrosis was identified by joint-like structures or complete clefts in calcified cartilage, and calcification was graded as absent, minor, or severe. Statistical analysis was performed using IBM SPSS version 21. Results: Pseudarthrosis was found in 51 (31.9%) first rib cartilages, with no significant gender or side predilection. Patients with pseudarthrosis were significantly older (mean 59.82 years) than those without (mean 31.35 years, p<0.001). Calcification was present in 71.9% of cases: minor in 17.5% and severe in 54.4%. Mean age increased with calcification severity. A strong association (p<0.001) was observed between pseudarthrosis and calcification; 94.1% of pseudarthrosis cases occurred in severely calcified cartilages. Conclusion: This study confirms an age-dependent increase in calcification and a strong association with pseudarthrosis, particularly severe calcification.
Arya et al. (Thu,) studied this question.