cervical rib

1. Cervical rib

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

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

6. 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)

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

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

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

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

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

13. Surgery
• If symptoms persist
• Remove surgical rib .

14. • Thank you.