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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 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]
  • A concurrent neurologic workup strongly suggested that her headache at initial presentation was a migraine and unrelated to ischemia.[omicsonline.org]
  • Published in association with the Society for Vascular Surgery, Rutherford’s Vascular Surgery presents state-of-the-art updates on all aspects of vascular health care.[books.google.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]
  • 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]
  • 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]
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]
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]
  • 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]
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]
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]
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
  • 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]
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]

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

  • 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]
  • Medical treatment Anti-inflammatory drugs and analgesics are provided as a conservative means of treatment.[physiotherapy-treatment.com]
  • Apply the latest treatments, rehabilitation protocols, and expertise of leading surgeons and therapists to help your patients regain maximum movement after traumatic injuries or to improve limited functionality caused by chronic or acquired conditions[books.google.com]
  • We discussed surgical treatment for symptomatic cervical rib with an investigation of the literature.[jstage.jst.go.jp]

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]
  • […] 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]

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]
Sex distribution
Age distribution

Pathophysiology

  • […] 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

  • 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]
  • Moreover, if denervation (that means that signs of nerve damage are detected given the progressive muscle waste) occurs, surgery is necessary also to prevent further worsening.[nshdubai.com]
  • […] evaluates the entire thoracic outlet technique in seated position, patient abducts the bilateral shoulders to 90 with the elbow flexed 90 patient opens and closes the hands for 3 minutes positive result reproduction of pain or paresthesias will often prevent[orthobullets.com]

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