Cervical rib is a congenital condition where an extra rib arises from the 7th cervical vertebrae, usually bilaterally. It can cause thoracic outlet syndrome with symptoms like pain in the arm and numbness in the fingers that worsen with shoulder movements. Diagnosis is made through x-rays and physical exam maneuvers. Conservative treatment involves pain medication and physical therapy while surgery to remove the extra rib may be considered if symptoms persist.

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.