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Thoracic outlet syndrome: a rare case with bilateral cervical ribs and bilateral anterior scalene hypertrophy

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Abstract

Thoracic outlet syndrome (TOS) is a rare neurovascular disorder generally caused by the presence of a cervical rib or hypertrophic scalene anterior muscle that can compress the brachial plexus and/or subclavian vessels. In the vascular form, the symptoms are caused by the compression of the artery and/or the subclavian vein. In the first case, the compression is caused by the cervical rib and leads to hypo-perfusion with cooling and cyanosis of the upper limb, while in the second case, the compression is caused by the anterior scalene muscle and leads to congestion, cyanosis, swelling and pain in the higher limb. In this paper, we describe a case with the simultaneous presence of a bilateral cervical rib and bilateral hypertrophy of the anterior scalene muscle. TOS diagnosis is based on neurological, clinical and instrumental tests, such as chest radiography and color Doppler ultrasonography. The treatment of these patients can be surgical or conservative.

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Authors and Affiliations

  1. Radiodiagnostic and Radiotherapy Unit, Department of Medical and Surgical Sciences and Advanced Technologies, “GF Ingrassia”, Via Santa Sofia 78, 95123, Catania, Italy

    Renato Farina, Pietro Valerio Foti, Francesco Aldo Iannace, Andrea Conti, Agata Ferlito, Monica Pennisi, Serafino Santonocito & Antonio Basile

  2. U.O.C. Diagnostica per Immagini, ASP 7 Ragusa “Guzzardi” Hospital, Vittoria, Italy

    Alessandro Conti

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  1. Renato Farina
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  2. Pietro Valerio Foti
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  3. Francesco Aldo Iannace
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  4. Andrea Conti
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  5. Agata Ferlito
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  6. Alessandro Conti
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  7. Monica Pennisi
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  8. Serafino Santonocito
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  9. Antonio Basile
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Contributions

All authors contributed to the study conception and design. Material preparation, data collection and analysis were performed by RF, PVF, FAI, AC, AF, AC, MP, SS and AB. The first draft of the manuscript was written by RF, and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

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Correspondence to Renato Farina.

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Farina, R., Foti, P.V., Iannace, F.A. et al. Thoracic outlet syndrome: a rare case with bilateral cervical ribs and bilateral anterior scalene hypertrophy. J Ultrasound 24, 331–336 (2021). https://doi.org/10.1007/s40477-019-00418-w

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  • DOI: https://doi.org/10.1007/s40477-019-00418-w

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