Imaging Findings reveal a
cervical rib on the left side with evidence of brachial plexus
compression. Thickening of the cords and trunk of the brachial plexus is
noted on the left.
Cervical rib found in course of routine investigations rarely gives rise
to symptoms, while when they are looked for in a symptomatic patient, they
are rarely found!
Occurs in about 0.5% people. It is slightly more common on the right
side, and is commoner in females. It may be associated with
other spinal anomalies.
4 pathological types seen :
Complete rib - articulates anteriorly with the manubrium or the 1st rib.
Incomplete rib - has broad end which expands into a knob like mass.
Incomplete rib with tapering end
with fibrous band attached to the manubrium / 1st rib.
Complete fibrous band.
The fibrous band types give more
Higher arching of Subclavian artery, post - stenotic dilatation, slowing
of blood flow (thrombosis), gangrene (Raynaud's phenomenon)
include higher arching of T1 segment of the brachial plexus, pain
& parasthesiae in ilnar area of arm, forearm and hand
If bony rib found -
If fibrous band - excision and/ or division of scalenus antecus.
If no fibrous band or rib - division of scalenus, and/or excision of
Cervical sympathectomy may be done.
Dr. Ashok Raghavan,
Manipal Hospital, Bangalore