CERVICAL RIB

Saturday, 14th Apr 2018

Cervical rib refers to an abnormal protrusion in the cervical region which can either be due to abnormal enlargment of transverse process of C7 vertebra to the first true rib or to the sternum but usually it is present posteriorly upto a short distance.

                CERVICAL RIB PUTTING PRESSURE ON THE LOWER CORD OF BRACHIAL PLEXUS

  It is usually diagnosed in middle age group person through is present since birth. The cause is thet by middle age, the shoulders start dropping which causes the cervical rib to get depressed and hence compressing the nerve root of the concerned region. The rib is usually asymptomatic but it may give rise to neurological symptoms if it exerts pressure on the subclavian artery or the brachial plexus like:-

    * Paraesthesia of hand

    * Hypothenar wasting

    * Atonia in the muscle of the shoulder girdle


FEATURES:-

1) Local symptoms:

          There is often a tender supraclavicular lump which is bony hard and is flexed when palpated

2) Sensory symptoms:

         a) Tingling in hands or fingers: confined either to radial side or ulnar side or sometimes involve even whole hand.

         b) Pain may somtimes radiate downwards from the arm.

3) Motor symptoms:

          a) Loss of gripping power of the hand.

          b) Tendency of dropping things from the hand.

          c) Wasting of the palmar muscles; either thenar or hypothenar or interossei muscles.

4) Vascular symptoms:

          a) Cold and clumpsy extremities, particularly the fingers.

          b) Skin colour change to blue associated with trophic changes.

          c) There is rare risk of gangrene.

          d) Radial pulse become feeble or may even be absent.

DIFFERENTIAL DIAGNOSIS:-

1) Peripharal vascular disease like Raynaud's disease

2) Other conditions:-

     * Syringomyelia

     * Polio

     * Muscular dystrophy

     * Motor neuron disease


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