Figure 2.

(A) Chest X-ray depicting ribs fanning out from their costovertebral joints (‘fan-like’ or ‘crab-like’ appearance) and a shortened spine with left lumbosacral scoliosis, altogether resulting in posterior rib fusions (arrowheads). A prominent intercostal hollow (*←→*) is seen, along with abnormal vertebral segmentation defects (‘pebble beach sign’) at the corresponding spinal segments. These findings characterise the spondylothoracic dysplasia subtype of JLS; notice the absence of intrinsic rib abnormalities (ie, aberrant rib count, bifurcations, thickenings, or more anteriorly located costal fusions). (B) Three-dimensional CT reconstruction of the same patient. JLS, Jarcho-Levin syndrome.