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. 2025 Apr 28;13(9):1014.
doi: 10.3390/healthcare13091014.

The Contribution of the Double Rib Contour Sign and the Rib Index to the Study of Scoliogeny, Thoracic Deformity, Progression, Outcome of Treatments and Costoplasty for Idiopathic Scoliosis

Theodoros B Grivas  1 , Anastasios G Christodoulou  2 , Evangelos A Christodoulou  3 , Galateia Katzouraki  4 , Marios G Lykissas  5 , Panayiotis J Papagelopoulos  6   7 , Elias C Papadopoulos  8 , Sotirios Papastefanou  9 , Nikolaos Sekouris  10 , Panayotis N Soucacos  7 , Konstantinos C Soultanis  11 , Elias Vasiliadis  12
Affiliations

The Contribution of the Double Rib Contour Sign and the Rib Index to the Study of Scoliogeny, Thoracic Deformity, Progression, Outcome of Treatments and Costoplasty for Idiopathic Scoliosis

Theodoros B Grivas et al. Healthcare (Basel). .

Abstract

This opinion article refers to the "double rib contour sign" and to the rib index (DRCS and RI), to their reliability study results in the chest radiographs of a control group and to their validity study results. These two parameters were introduced by the first author in this report. The introduction of the Segmental Rib Index (SRI) and its relation to spinal deformity is also discussed. The RI has been confirmed to be a strong surrogate for scoliometric readings in idiopathic scoliosis (IS). The clinical applications of the RI are analyzed for the following: (a) the documentation of deformity; (b) the assessment of physiotherapy outcomes (PSSEs); (c) the documentation of the outcomes of brace treatment; (d) the documentation of the pre- and post-operative assessment of thoracic deformity correction in different types of instrumentation; (e) its usage in prognosticating accelerated deterioration in skeletally mature adolescent idiopathic scoliosis (AIS) curves of 40-50 degrees; and (f) its usage in the recognition of the proper rib level for thoracoplasty/costoplasty. The emerging etiological-scoliogenic implications from the use of the DRCS and RI are described. The rotation of the trunk and vertebral bodies as interrelated, but distinct parameters are finally analyzed.

Keywords: DRCS; RI; SRI; costoplasty; double rib contour sign; idiopathic scoliosis; progression; rib hump; rib index; scoliogenesis; segmental rib index; thoracic deformity; treatment.

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Conflict of interest statement

The authors declare that they have no conflicts of interest concerning this article.

Figures

Figure 1
Figure 1
The double rib contour sign (DRCS) of the rib cage in a standing spinal radiograph (from our citation no. [12]).
Figure 2
Figure 2
The rib index (RI) of the thoracic cage in a standing spinal radiograph (from citation no. [12]).
Figure 3
Figure 3
The Segmental Rib Index (SRI) of the thoracic cage in a standing spinal radiograph (from our citation no. [16]).
Figure 4
Figure 4
The assessment of pre-brace treatment RI and early post-brace RI. (a,b) depict the radiographs and (c,d) the clinical pictures of a girl wearing the brace (modified from our reference no. [16]).
See this image and copyright information in PMC

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