Cervical rib

cervical rib

1. Cervical rib

2. Definition:It is basically a congenital condition in which supernumerary (Extra rib)usually arising from 7 th cervical vertebrae. Usually bilateral

3. Pathology Persistent ossification of C7 lateral costal element which gets reabsorbed.

4. Clinical presentation Asymptomatic Pain(Dull aching) and parasthesia in ulnar aspect of hand and little fingers. Tingling Of forearm and Hand-”Falling asleep” due to circulatory insufficiency. Diminished sensations in medial 11/2 digits Symptoms are accentuated in downward displacement of shoulder girdle(heavy weight lifting)

5. Signs 1)Thoracic outlet syndrome 2)Pallor 3)Cyanosis 4)Trophic changes-Glossy skin,brittle nails,ulcer
5)Gangrene 6)Adsons test positive

6. Differential diagnosis 1) Herniated cervical disc 2) Hyperabduction syndrome 3) Costoclavicular compression syndrome

7. 1) Herniated disc-Usuakky C5.Pain aggravates on hyperextension of neck. 2) Hyperabduction syndrome-Test positive 3) Costoclavicular compression syndrome-Test positive

8. Investigations 1)Plain x-ray cervical spine 2)Chest x-ray

9. Treatment Conservative 1)Pain medications-NSAIDS 2)Avoid heavy weight lifting 3)Physio-Self resisted elevation and adduction of scapula.Endurance trailing for sports.

10. Surgery If symptoms persist Remove surgical rib .

11. Thank you.