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Cervical Rib Syndrome


Presentation

  • Five patients presented with an ischemic upper extremity without thrombosis and underwent transaxillary first rib and cervical rib resection.[ncbi.nlm.nih.gov]
  • […] plexopathy, caused by compromise of the distal C8 anterior primary ramus or proximal lower trunk fibers by a congenital band extending from a rudimentary cervical rib to the first thoracic rib; rare disorder, found mostly in young to middle-aged women, which presents[medical-dictionary.thefreedictionary.com]
  • A concurrent neurologic workup strongly suggested that her headache at initial presentation was a migraine and unrelated to ischemia.[omicsonline.org]
  • Cervical rib with stroke as the initial presentation. Neurol India. 2010;58(4):645‒647. Jusufovic M, Sandset EC, Popperud TH, et al.[medcraveonline.com]
  • A 20-year-old male presenting with pain, paresthesia and weakness the of neck, right shoulder and arm was admitted to our hospital. This case was diagnosed as TOS caused by cervical rib by physical and radiological examination.[jstage.jst.go.jp]
Arm Pain
  • From WikiCNS Rare entity associated with upper extremity weakness (atrophy of the thenar eminence), arm pain (medial forearm), and cervical ribs Occurs typically in young and middle aged females Symptoms due to compressive fibrous band, continuous with[prod.wiki.cns.org]
  • Snapshot A 25-year-old woman with no history of trauma presents with right arm pain. She reports that her right arm is easily fatigable, especially after she cooks.[medbullets.com]
  • If the patient has a reproduction of arm pain or numbness, consider thoracic outlet syndrome. Radial artery palpation can also diminish in addition to this.[boneandspine.com]
  • I would recommend that not withstanding the findings of the rib on the X-ray, get her examined by a competent orthopaedic surgeon to exclude the other causes of should and arm pain.[doctor.ndtv.com]
  • Thoracic outlet syndrome symptoms include neck pain, shoulder pain, arm pain, numbness and tingling of the fingers, and impaired circulation to the extremities (causing discoloration).[medicinenet.com]
Raynaud Phenomenon
  • phenomenon – a condition that affects the blood supply to the fingers and toes, turning them white a blood clot that forms in the subclavian artery – which can affect the blood supply to the fingers, causing small red or black patches on the skin swelling[nhs.uk]
  • He had episodes of Raynaud’s phenomenon in cold weather. The patient was non smoker and a non alcoholic. There was no previous hospitalization and surgical intervention. No significant family history could be found.[pjmhsonline.com]
  • phenomenon • compression of peripheral nerves - pain, paresthesias, motor weakness specific compression syndromes • Scalenus Anticus Syndrome • Cervical Rib Syndrome • Costoclavicular Syndrome • Hyperabduction syndrome scalenus anticus syndrome • Compression[quizlet.com]
  • Unusual reason for unilateral (corrected) Raynaud's phenomenon with intensification when the arms are elevated. Dtsch Med Wochenschr. 2009;134:F3. Spears J, Kim DC, Saba SC, et al. Anatomical relationship of Roos' type 3 band and the T1 nerve root.[medcraveonline.com]
  • The retropectoralis minor space is a very rare potential site of compression. 3 In neurogenic TOS, neurogenic symptoms occur in the upper extremity and may radiate to the shoulder, neck, and occipital regions if the upper trunk is involved; Raynaud phenomenon[ajnr.org]
Italian
  • Syndrome de la pince omo-costo-claviculaire, Syndrome de la traversée thoracobrachiale, Syndrome de la côte cervicale Polish Zespół żebra szyjnego Hungarian Nyaki borda syndroma Norwegian Halsribbensyndrom, Halsribbeinssyndrom German Halsrippensyndrom Italian[fpnotebook.com]
Inflammation
  • […] jugular vein is also noted in some cases of thoracic outlet syndrome. 35 It is postulated that aggregated costochondral calcifications may predispose to osteophyte formation and stress-induced occult first rib fractures, and that neighbouring soft tissue inflammation[medcraveonline.com]
Decreased Radial Pulse
  • Interpretation - Positive test finding ( Decreased Radial Pulse and/or Distal extremity pain reproduced ) suggests interscalene compression.[physiotherapy-treatment.com]
Water Hammer Pulse
  • Immediately proximal to the dilatation, a water hammer pulse was dopplered, with loss of pulse in the artery distal to the rib extending into the axillary artery.[omicsonline.org]
Decreased Radial Pulse
  • Interpretation - Positive test finding ( Decreased Radial Pulse and/or Distal extremity pain reproduced ) suggests interscalene compression.[physiotherapy-treatment.com]
Shoulder Pain
  • Thoracic outlet syndrome symptoms include neck pain, shoulder pain, arm pain, numbness and tingling of the fingers, and impaired circulation to the extremities (causing discoloration).[medicinenet.com]
  • A great number of subjects with CTS presented with history of neck and shoulder pain suggestive of TOS. 61 Histopathological studies, on human cadavers, had demonstrated the structural changes induced by cervical rib compression in the lower trunk of[medcraveonline.com]
  • Mr D is a 38 old year man with chronic shoulder pain after a rotator cuff tear playing cricket. It responded well to treatment, but he knows he must do his exercises every day; for two years he couldn't sleep on that shoulder. 13.[chiropractic-help.com]
  • The now 34-year-old patient continued to complain of left shoulder pain, numbness, heaviness and weakness of the left upper extremity that were invalidating. He had been unable to work for 12 months.[medschool.lsuhsc.edu]
Narrow Chest
  • First thoracic vertebra 1T; 3, 7 cervical vertebrae Figure 4 This 3D coronal image displays thin subcutaneous tissues accentuating the narrow chest with the forward dropping right shoulder as compared to the elevated left shoulder; resected right middle[mdmag.com]
Osteophyte
  • Costochondral calcification, osteophytic degeneration, and occult first rib fractures in patients with venous thoracic outlet syndrome. J Vasc Surg. 2012;55(5):1363‒1369. Gelabert HA, Jabori S, Barleben A, et al.[medcraveonline.com]
Myalgia
  • […] compression (venous TOS). 36 Regrown, remaining or residual cervical or first rib is the cause of recurrent TOS. 37‒39 Some authors described a case of a young woman with pain in the left forearm, accompanied by intermittent claudication, weight loss, myalgias[medcraveonline.com]
Facial Numbness
  • Prior to this she reports no prior history of stroke symptoms, facial numbness, headache, clotting or bleeding disorders. She had a history of irritable bowel syndrome and left ulnar neuropathy, for which she was taking hyoscyamine and gabapentin.[omicsonline.org]
Vaginal Discharge
  • There may also be increased vaginal discharge. The papanicolaou test should be done routinely every year in women over 40 to rule out the possibility of cervical malignancy.[medical-dictionary.thefreedictionary.com]
Vaginal Bleeding
  • One of the first warning signs of cervical cancer is vaginal bleeding between menstrual periods, after coitus, or after menopause is established. There may also be increased vaginal discharge.[medical-dictionary.thefreedictionary.com]
Cervicobrachial Syndrome
  • syndrome 2016 2017 2018 2019 Billable/Specific Code Type 2 Excludes cervical disc disorder ( M50.- ) thoracic outlet syndrome ( G54.0 ) rib Q76.5 ICD-10-CM Codes Adjacent To Q76.5 Q76.415 …… thoracolumbar region Q76.419 …… unspecified region Q76.42 Congenital[icd10data.com]
Numbness of the Hand
  • Symptoms include weakness or numbness of the hand; decreased size of hand muscles, which usually occurs on one side of the body; and/or pain, tingling, prickling, numbness and weakness of the neck, chest, and arms.[my.clevelandclinic.org]
Slurred Speech
  • Given her episode of facial tingling and reported episode of slurred speech, a stroke evaluation was undertaken. CT and MRI of the head showed no acute intracranial process, and a transthoracic echocardiogram was negative.[omicsonline.org]
Dropping Things
  • (b) Tendency of dropping things from the hand. (c) Wasting of palmar muscles; either thenar or hypothenar or interossei muscles. Vascular Symptoms (a) Cold and clumsy extremities, particularly the fingers.[physiotherapy-treatment.com]
Motor Symptoms
  • Motor Symptoms (a) Loss of gripping power of the hand. (b) Tendency of dropping things from the hand. (c) Wasting of palmar muscles; either thenar or hypothenar or interossei muscles.[physiotherapy-treatment.com]

Workup

  • A concurrent neurologic workup strongly suggested that her headache at initial presentation was a migraine and unrelated to ischemia.[omicsonline.org]
  • An evaluation of the probability of malignant causes and the effectiveness of physicians’ workup. J Fam Pract. 1988;27:373–6.[balancechiropracticva.com]
Mediastinal Shift
  • The backward displaced manubrium and body of the sternum (not displayed) splay apart the right and left brachiocephalic veins (BRV), shifting the mediastinal contents to the left of midline accentuating the mediastinal shift of the great vessels, including[mdmag.com]

Treatment

  • The surgery combined with anticoagulation treatment can improve the treatment outcome of ATOS. PMC Free PDF PMC Free Full Text FREE Publisher Full Text Thirty-Day Outcomes Following Surgical Decompression of Thoracic Outlet Syndrome.[unboundmedicine.com]
  • What is the treatment for thoracic outlet syndrome? Treatment depends on the underlying cause.[patient.info]
  • Medical treatment Anti-inflammatory drugs and analgesics are provided as a conservative means of treatment.[physiotherapy-treatment.com]
  • Patient Population: Prevalence and Epidemiology Knee // Shoulder & Elbow // Hip // Spine // Foot & Ankle // Hand & Wrist Fragility Fractures: Diagnosis and Treatment Shoulder & Elbow The Characteristics of Surgeons Performing Total Shoulder Arthroplasty[mdedge.com]
  • Finally, the natural history and the conservative treatment of each condition are discussed accordingly. NEW![books.google.com]

Prognosis

  • What is the outlook (prognosis) for thoracic outlet syndrome? In most people with thoracic outlet syndrome, the outlook is generally good and symptoms often improve over time.[patient.info]

Etiology

  • A significant variable in results was the etiology of the symptoms.[ncbi.nlm.nih.gov]
  • Hugl B, Oldenburg WA, Hakaim AG, Persellin ST (2007) Unusual etiology of upper extremity ischemia in a scleroderma patient: thoracic outlet syndrome with arterial embolization.J VascSurg 45: 1259-1261.[omicsonline.org]
  • […] thoracic outlet the thoracic outlet is above the first rib and behind the clavicle classified into three types neurogenic (compression of brachial plexus) arterial (obstruction in arteries) venous (obstruction in veins) Epidemiology demographics adults Etiology[medbullets.com]
  • […] the problem - there are often 1 or more congenital anomalies that predispose someone to sxs • Accurate diagnosis is based on total clinical picture - dx based on clinical exam, electrodiagnostic studies, arterial and venous studies, and x-rays • Bony etiology[quizlet.com]
  • Cervical rib fracture: an unusual etiology of thoracic outlet syndrome in a child. Pediatr Neurosurg. 2007;43(4):293‒296. Sanli EC, Aktekin M, Kurtoglu Z. A case of large scalenus minimus muscle. Neurosciences. 2007;12(4):336‒337.[medcraveonline.com]

Epidemiology

  • Patient Population: Prevalence and Epidemiology Knee // Shoulder & Elbow // Hip // Spine // Foot & Ankle // Hand & Wrist Fragility Fractures: Diagnosis and Treatment Shoulder & Elbow The Characteristics of Surgeons Performing Total Shoulder Arthroplasty[mdedge.com]
  • […] vessels as it passes through the thoracic outlet the thoracic outlet is above the first rib and behind the clavicle classified into three types neurogenic (compression of brachial plexus) arterial (obstruction in arteries) venous (obstruction in veins) Epidemiology[medbullets.com]
  • […] disorder resulting from compression of the brachial plexus and/or subclavian vessels in the interval between the neck and axilla treatment may be nonoperative or include surgical decompression or a vascular procedure depending on the specific etiology Epidemiology[orthobullets.com]
  • […] physiopathology of neurologic TOS consists of disturbed functionality (the conduction speed of the nervous impulse decreases) and disturbed neuronal trophicity (reversible or irreversible degenerescence). 18,19 TOS clinical features ( Tables 5-8 ) Although epidemiologically[tmj.ro]
Sex distribution
Age distribution

Pathophysiology

  • […] who reported a case of osteoid osteoma of the 1 st rib and case presented as thoracic outlet syndrome. [ 3 ] In 2009 White PW et al discussed in detail the cervical rib causing the arterial type of TOS with subclavian artery compression and etiology, pathophysiology[pubs.sciepub.com]
  • […] population demographics females males (3:1) tend to be thin with long necks and drooping shoulders age 20-60 type neurogenic is most common (95%) vascular may be venous (4%) or arterial ( 1%) more common in athletic males compared to athletic females Pathophysiology[orthobullets.com]

Prevention

  • Screening and prevention of colorectal cancer Source: Finnish Medical Society Duodecim This article is freely available only to users in the UK.[evidence.nhs.uk]
  • Is it possible to prevent thoracic outlet syndrome? It's possible to prevent thoracic outlet syndrome by maintaining relaxed tissues of the upper chest.[medicinenet.com]
  • If you develop blood clots you may be prescribed thrombolytics to break them up, and anticoagulants to prevent further clots developing. If these treatments don't help, surgery may be an option.[nhs.uk]
  • Treatment with an anticoagulant may then be continued for a period of time to prevent further clots. Surgery may also be needed to relieve any squashing (compression) of your blood vessels.[patient.info]
  • The need of early detection of lesions caused by emboli at an early stage is extremely important to prevent the adverse vascular events.[pjmhsonline.com]

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