Tag Archives: Cervical rib

Thoracic Outlet Syndrome

Left cervical rib.

This is a radiograph of a patient who has been experiencing intermittent claudication of the left arm for many years.

left cervical rib

Case submitted to Radiopaedia by Dr. Jan Fank Gerstenmaier (link)

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Cervical Rib

cervical rib is a supernumerary (or extra) rib which arises from the seventh cervical vertebra. It is a congenital abnormality located above the normal first rib. A cervical rib is present in only about 1 in 500 (0.2%) of people; in even rarer cases, an individual may have two cervical ribs. Cervical ribs are sometimes known as “neck ribs”. (from wikipedia)

mouseover for labels       image from pramodrad.blogspot

There is complete cervical rib on the right side: The left cervical rib has an accessory articulation with the typical first rib (synostosis). There is pseudoarthrosis in the midst of the fusion.

The presence of a cervical rib can cause a form of thoracic outlet syndrome due to compression of the lower trunk of the brachial plexus or subclavian artery. These structures are entrapped between the cervical rib and scalenus muscle.

Compression of the brachial plexus may be identified by weakness of the muscles around the muscles in the hand, near the base of the thumb. Compression of the subclavian artery is often diagnosed by finding a positive Adson’s sign on examination, where the radial pulse in the arm is lost during abduction and external rotation of the shoulder. (wikipedia)

 

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