Bilateral cervical ribs forming pseudoarthrosis with the first ribs co-occurring with an aberrant right subclavian artery

While anatomical variations in both aortic arch branching and rib cage development are considered relatively common, compared to various other anomalies, their coexistence seems to be underreported. We present a case report of a 70-year-old Polish woman with bilateral complete cervical ribs forming a pseudoarthrosis with the superior surface of the first ribs, and an aberrant right subclavian artery (arteria lusoria) with a retroesophageal course. We believe that the frequency of their co-occurrence may be higher than would be expected based on statistical probability derived from their prevalence in the general population, possibly due to a common genetic mechanism leading to disruption in the segmental development of both vascular and skeletal systems. We also believe that the combination of both anomalies may render synergistic consequences on the right subclavian artery patency and may complicate intravascular procedures.