Diagnosis: Cervical Ribs

Findings on Imaging (Radiograph):

  • X-ray of the chest reveals a supernumerary rib arising from the seventh cervical vertebra, which is known as a cervical rib.
  • The cervical rib is seen as a bony projection that extends from the transverse process of the seventh cervical vertebra.
  • There may be associated findings such as an enlarged transverse process or a scalene tubercle.

Next Steps in Management:

  • Further imaging may be necessary to evaluate for any associated vascular or neurogenic compression, as cervical ribs can be associated with thoracic outlet syndrome.
  • Patients with thoracic outlet syndrome may benefit from physical therapy, nonsteroidal anti-inflammatory drugs (NSAIDs), and/or surgical intervention.

Key Take Away Points:

  • Cervical ribs are an anatomical variant in which an extra rib arises from the seventh cervical vertebra.
  • The presence of a cervical rib can lead to thoracic outlet syndrome, which may cause pain, numbness, tingling, and weakness in the upper extremities.
  • Imaging, such as x-ray or CT, can be helpful in identifying the presence of a cervical rib, but further imaging may be necessary to evaluate for any associated vascular or neurogenic compression.
  • Management options for thoracic outlet syndrome may include physical therapy, NSAIDs, or surgical intervention.

Credit: Submitted by Dr. Ellie Goulding MD to radRounds Radiology Network