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Cervical Rib Syndrome

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  1. See also
    1. Thoracic Outlet Syndrome
  2. Epidemiology
    1. Most common neurovascular compression at neck base
  3. Anatomy
    1. Cervical rib (extra rib) arises from C7 vertebra
    2. Rib narrows interval between scalenes
      1. Higher barrier for nerves and vessels to pass over
      2. Compression Worsened by
        1. Shoulder sag (in elderly or Muscle Weakness)
        2. Carrying heavy object in hand
    3. Levels C8 to T1 most commonly affected
  4. Symptoms
    1. Affects hand and inner forearm
    2. Pain and Paresthesia along Ulnar Nerve course
    3. Hand weakness, numbness, and clumsiness
    4. Associated symptoms may be variably present
      1. Hand cold sensation
      2. Raynaud's Phenomenon
      3. Gangrene
  5. Sign
    1. Palpable cervical rib
    2. Tender brachial Plexus distribution
    3. Muscle Weakness and atrophy (lower trunk)
      1. Interosseus muscles
      2. Hypothenar muscles
    4. Sensation decreased
      1. Ulnar forearm
      2. Arm
      3. Ulnar 1.5 fingers
    5. Circulatory insufficiency
      1. Swelling
      2. Cold sensation
      3. Distal cyanosis
      4. Trophic skin change
    6. Adson's Test
  6. Diagnostics
    1. Chest XRay
      1. Extra rib at C7 vertebra (Often bilateral)
    2. Electromyogram

Cervical Rib Syndrome (C0007856)

Definition (MSH)A condition associated with compression of the BRACHIAL PLEXUS; SUBCLAVIAN ARTERY; and SUBCLAVIAN VEIN at the thoracic outlet and caused by a complete or incomplete anomalous cervical rib or fascial band connecting the tip of a cervical rib with the first thoracic rib. 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. (Adams et al., Principles of Neurology, 6th ed, p214)
ConceptsDisease or Syndrome (T047)
ICD9353.0
MSHD002573
EnglishAnomalous Cervical Rib Syndrome, Arterial thoracic outlet syndrome due to cervical rib, Cervical Rib Syndrome, Cervical rib syndrome -RETIRED-, Cervical Rib Syndromes
Spanishsindrome arterial del estrecho superior del torax por costilla cervical, sindrome de la costilla cervical, sindrome de la costilla cervical - RETIRADO -
Parent ConceptsThoracic Outlet Syndrome (C0039984), Systemic arterial finding (C0577829), Arteriopathic disease (C0852949), Vascular thoracic outlet syndrome (C1263854), Ambiguous concept (C1274012), Thoracic outlet syndrome associated with cervical rib (C1532198)
SourcesMSH, MTH, MTHICD9, NDFRT, SCTSPA, SNOMEDCT
Derived from the NIH UMLS (Unified Medical Language System)



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