Case 16 Cervical Rib

Case 16

                                                            Cervical Rib

What Happened ?                                                       How it disturbs you ?

Examination

Introduction ownself

Exposure

Look

            Surgical Scar on Neck

            Atrophy of Muscles on Arm , Forearm , hand

            Wasting of thenar / hypothenar muscles

            Finger tip necrosis or well perfused

Feel

            Palpate tender swelling on supraclavicular region

Neurovascular examination

            Vascular

                        Pulsation – Brachial /Radial / Ulnar

                        Claudication on elevating limb

                        Adson’s test

                        Roos test

                       

            Neurological

                        T 1 Symptoms , T 1 hypoaesthesia , Intrinsic weakness

                        Weakness and clumsiness of hand

                       

Presentation – Vascular / Neural and local symptoms

Local Symptoms

            Tender supraclavicular lump

            Bony hard and fixed

           

Neural Symptoms

            Thenar wasting , atrophy of finger pulps , Ulcers

Vascular Symptoms

            Ulcers , Cold / White or mottled

            Adson test / Roos test +

            Bruit – supraclavicular area with stethescope