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]
Material and Methods We present series of 8 patients operated by two consultants in our department. All patients presented with symptoms of thoracic outlet syndrome of varying intensity. [pubs.sciepub.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]
Entire Body System
- Pain
[…] damage of the arterial lining and production of small emboliResults in no general or local neck symptoms usuallyComplain of pain in the ulnar forearm and hand worse after activity and carrying parcelsMay be weakness and clumsiness and excessive sweating [orthopaedicsone.com]
[…] image shows illustrations related to injury neck thoracic outlet syndrome trauma scalene muscles stretched strained brachial plexus arm nerves subclavian artery clavicle rib cervical swelling spasm compresses scar tissue entrapping symptoms tingling pain [medicalexhibits.com]
History: 10 year old female with neck pain. Cervical Ribs : Frontal radiograph of the neck reveals bilateral ribs articulating with the C7 transverse processes. The cervical rib on the left is larger (labeled). [radiologypics.com]
The pain of TOS is sometimes confused with the pain of angina (chest pain due to an inadequate supply of oxygen to the heart muscle), but the two conditions can be distinguished because the pain of thoracic outlet syndrome does not occur or increase when [my.clevelandclinic.org]
One can even experience facial pain, jaw pain, ear pain and pain on the front of your chest. Unfortunately, the symptoms of neurogenic TOS can be vague and non-specific. [neuropaxclinic.com]
- Weakness
[…] 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 with unilateral hand wasting and weakness [medical-dictionary.thefreedictionary.com]
[…] damage of the arterial lining and production of small emboliResults in no general or local neck symptoms usuallyComplain of pain in the ulnar forearm and hand worse after activity and carrying parcelsMay be weakness and clumsiness and excessive sweating [orthopaedicsone.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]
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]
[…] base of the neck clinical picture: venous vascular TOS • Rapid onset symptoms - Follows limb exertion • Edema and cyanosis of the upper extremity • May also have distended veins in shoulder or chest clinical picture: arterial vascular TOS • Pallor • Weak [quizlet.com]
- 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]
The patient may have pain radiating along the nerves of the arm or pain in the neck and shoulder. At times this may be severe causing patient to have a severe burning type of pain along the arm. [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]
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]
- Pallor
[…] artery at the base of the neck clinical picture: venous vascular TOS • Rapid onset symptoms - Follows limb exertion • Edema and cyanosis of the upper extremity • May also have distended veins in shoulder or chest clinical picture: arterial vascular TOS • Pallor [quizlet.com]
[…] as pain vascular venous episodic cyanotic discoloration and swelling of the limb distended veins diffuse deep pain in the arm and forearm upper extremity heaviness worse after activity arterial unilateral Raynaud-type symptoms episodic coolness and pallor [orthobullets.com]
Symptoms include Spasm of vessels of hand leading to pallor in one or more of fingers Thrombosis or embolism of the arteries leading to weak or no pulse in the affected arm, cold fingers, hands or arms Weakness of arm or neck Aneurysm Muscle atrophy, [boneandspine.com]
Surgical treatment is indicated in cases of failure in clinical treatment (after 6 months without improvement or symptom recurrence), uncontrolled pain and paresthesia, in addition to vascular impairment (pallor, reduced pulses, cyanosis, Raynaud's phenomenon [pjmhsonline.com]
The indication for surgery was made respecting the criteria: symptoms (pain, swelling or heaviness decreased temperature, paresthesias) plus objective signs, static or dynamic (pallor or coolness, venous engorgement, cyanosis, gangrene of the digits). [tmj.ro]
- Disability
Indications for surgery were disabling pain and paresthesia and failure to respond to conservative treatment. [ncbi.nlm.nih.gov]
Accessory rib arising from the 7 th cervical vertebral body, usually bilaterally Treatment Most patients improve with exercise and physical therapy Surgical intervention is unusual Indications for surgical resection of the accessory rib may include disabling [learningradiology.com]
One retrospective analysis of patients with nonspecific neurogenic thoracic outlet syndrome demonstrated work disability at 1 year after surgery in 60% of patients. [emedicine.medscape.com]
1 year after surgery, and compared with a nonsurgical sample of TOS patients, those receiving surgery had 50% greater medical costs and were three to four times more likely to be work disabled. 33,34 The most severe presentation of the arterial TOS is [tmj.ro]
Cardiovascular
- Thrombosis
Five patients presented with an ischemic upper extremity without thrombosis and underwent transaxillary first rib and cervical rib resection. [ncbi.nlm.nih.gov]
Deep vein thrombosis is more common in the legs. [hopkinsmedicine.org]
Medicine (Baltimore) 2019; 98(11):e14778 Jiang S, Shen H, … Lu H CONCLUSIONS: Successful treatment of ATOS depends upon urgent assessment, accurate identification of causative factors and compression site and early diagnosis before the event of arterial thrombosis [unboundmedicine.com]
Findings and Their Effect on Diagnosis and Treatment Comprehensive surgical management of the competitive athlete with effort thrombosis of the subclavian vein (Paget-Schroetter syndrome). Original Text by Clifford R. Wheeless, III, MD. [wheelessonline.com]
Symonds CP (1927) (2,3) Cervical Rib: Thrombosis of Subclavian Artery. Contralateral Hemiplegia of Sudden Onset, probably Embolic.Proc R Soc Med 20: 1244-1245. [omicsonline.org]
- Decreased Radial Pulse
Interpretation - Positive test finding ( Decreased Radial Pulse and/or Distal extremity pain reproduced ) suggests interscalene compression. [physiotherapy-treatment.com]
- Weak Pulse
It is also known as amplitude, expansion or size of pulse, a weak pulse signifies narrow pulse pressure 5. Radiologia – Radiology is a specialty that uses medical imaging to diagnose and treat diseases seen within the body. [wikivisually.com]
- Chest Pain
The pain of TOS is sometimes confused with the pain of angina (chest pain due to an inadequate supply of oxygen to the heart muscle), but the two conditions can be distinguished because the pain of thoracic outlet syndrome does not occur or increase when [my.clevelandclinic.org]
Musculoskeletal
- Cervical Rib Syndrome
English Cervical Rib Syndrome, Cervical Rib Syndromes, Syndrome, Cervical Rib, Syndromes, Cervical Rib, cervical rib syndrome (diagnosis), cervical rib syndrome, Anomalous Cervical Rib Syndrome, Cervical Rib Syndrome [Disease/Finding], Cervical rib syndrome [fpnotebook.com]
[…] is: 8 Images & Illustrations of cervical rib syndrome Translation Find a translation for the cervical rib syndrome definition in other languages: Discuss these cervical rib syndrome definitions with the community: Word of the Day Would you like us to [definitions.net]
(Adams et al., Principles of Neurology, 6th ed, p214) This graph shows the total number of publications written about "Cervical Rib Syndrome" by people in this website by year, and whether "Cervical Rib Syndrome" was a major or minor topic of these publications [profiles.umassmed.edu]
But yesterday I was advised chest x-ray where it shows that I am suffering from Cervical Rib Syndrome. I have taken physiotherapy also but nothing worked. [practo.com]
True neurogenic thoracic outlet syndrome, in which the proximal lower trunk of the brachial plexus is compromised by a radiolucent band extending from a rudimentary cervical rib to the first rib. cervical rib syndrome Pain and paresthesias in the the [medical-dictionary.thefreedictionary.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]
In 1993, he progressively developed shoulder and arm pain along with numbness of upper limb down to 4th and 5th digits. He had gained 10 kgs since the operation. [medschool.lsuhsc.edu]
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]
Neurologic
- Tingling
[…] yet) This image shows illustrations related to injury neck thoracic outlet syndrome trauma scalene muscles stretched strained brachial plexus arm nerves subclavian artery clavicle rib cervical swelling spasm compresses scar tissue entrapping symptoms tingling [medicalexhibits.com]
Review of systems revealed a headache, left upper extremity weakness, and a cold sensation and tingling in the left hand. She was otherwise negative for lateralizing symptoms or visual field deficits. [omicsonline.org]
The resulting scar tissue may cause pain, numbness, tingling, headaches, or weakness in the arm and hand. [nyulangone.org]
Specific risks and issues of not doing surgery If the compression on the nerves is ongoing, there will be persistence of pain, numbness and tingling. [nshdubai.com]
If the client experiences the referral of sensory symptoms such as pain, tingling, or numbness into the upper extremity during this test, this is also considered a positive finding and indicates direct compression of the brachial plexus between the anterior [learnmuscles.com]
- Paresthesia
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]
[…] will often prevent the patient from completing the test for the full 3 minutes normal person have discomfort with this manuever, but are able to complete it resolution of pain or paresthesias with dropping of the arms Cyriax release test evaluates the [orthobullets.com]
Clinical manifestations may include pain in the neck and shoulder which radiates into the upper extremity, PARESIS or PARALYSIS of brachial plexus innervated muscles; sensory loss; PARESTHESIAS; ISCHEMIA; and EDEMA. [profiles.umassmed.edu]
[…] thoracic outlet syndrome Caused by compression of the lower portion of the brachial plexus Clinical manifestations may include pain in the neck and shoulder which radiates into the upper extremity affecting course of the ulnar nerve-hand and inner forearm Paresthesias [learningradiology.com]
- Irritability
Yet, it is known that when the blood vessels and/or nerves in the tight passageway of the thoracic outlet are abnormally compressed, they become irritated and can cause TOS. [my.clevelandclinic.org]
[…] symptoms rarely develop before the age of 30 years and are more common in womenPain and symptoms usually evident in the distribution of the lower roots of the brachial plexus (C8 & T1)The subclavian artery is rarely compressed but may be narrowed by irritation [orthopaedicsone.com]
Thoracic Outlet Syndrome (TOS) is characterized by upper extremity pain or parasthesia caused from occlusion, compression, injury or irritation to the neurovascular structures traversing the thoracic outlet. [balancechiropracticva.com]
The BP, especially the lower elements, C8 and T1 spinal nerves and lower trunk, becomes compressed/irritated in the interscalenic triangle. [medschool.lsuhsc.edu]
Functional factors Essential causes are the compression of the lumen of the subclavian artery, the irritation of the brachial plexus, the irritation of the sympathetic fibers, thromboses and embolism of the arteries, the compression of the lumen of the [tmj.ro]
- 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]
- Cervicobrachial Syndrome
( Q77.2 ) cervical or first Q76.5 (syndrome) Syndrome - see also Disease cervical (root) M53.1 ICD-10-CM Diagnosis Code M53.1 Cervicobrachial syndrome 2016 2017 2018 2019 Billable/Specific Code Type 2 Excludes cervical disc disorder ( M50.- ) thoracic [icd10data.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]
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]
and found no randomized evidence that either treatments is better than no treatment at all. [emedicine.medscape.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]
Medical treatment Anti-inflammatory drugs and analgesics are provided as a conservative means of treatment. [physiotherapy-treatment.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]
[…] 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]
[…] neurovascular 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 [orthobullets.com]
[…] in 2013 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 [pubs.sciepub.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]
The epidemiological, morphological, and clinical aspects of the cervical ribs in humans. Biomed. Res. Int., 2016:8034613, 2016. [ Links ] Vemuri, C.; McLaughlin, L. N.; Abuirqeba, A. A. & Thompson, R. W. [scielo.cl]
Discu ssion : [ Epidemiology | Clinical Presentation | Clinical Examination | Diagnostic Management | Therapeutic Management] Epide miology: TOS commonly develops during the 3rd or 4th decade, more often in women, under the combination of a peculiar cervical [medschool.lsuhsc.edu]
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
The vascular surgeon will find here new variants on the usual operative techniques and much stimulating discussion of complications and their prevention and treatment. [books.google.com]
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]
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]