Cervical Ribs and Thoracic Outlet Syndrome

History: 10 year old female with neck pain.

Cervical Ribs: Frontal radiograph of the neck reveals bilateral ribs articulating with the C7 transverse processes. The cervical rib on the left is larger (labeled).

This is an example of cervical ribs, which are seen in less than 1% of the population. Cervical ribs are on the differential diagnosis for neck pain, and can be a cause of thoracic outlet syndrome. The thoracic outlet contains multiple spaces including the subcoracoid tunnel, costoclavicular space, and interscalene triangle. Compression of neurovascular structures in these spaces by cervical ribs causes thoracic outlet syndrome.  Thoracic outlet syndrome can be classified as neurological in which compression of the brachial plexus causes symptoms, or vascular in which compression of the subclavian vessels causes symptoms.

Read about management here.