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Solid Swellings of the Posterior Triangle: Cervical Ribs

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Abstract

In humans, a “cervical rib” is an extra (supernumerary) rib, which arises from the seventh cervical vertebra. It is a congenital anomaly and is located above the normal first rib. However, it can also originate from the sixth or the fifth cervical vertebra. Cervical ribs are known to cause thoracic outlet syndrome (TOS) or brachial plexopathy in up to 10% of the affected individuals, resulting in serious neurological and vascular symptoms in the upper arm. In approximately 90% of cases, it does not cause symptoms, and clinical examination of the neck usually reveals no abnormalities. The abnormal rib is generally discovered incidentally, most often during X-rays and computed tomography (CT) scans. Differentials include other causes of a lateral solid swelling in the neck and other causes of pain and paresthesia of the shoulders, arms, and hands. A cervical rib is usually asymptomatic and does not require removal. Patients with mild symptoms require physiotherapy, whereas those with severe symptoms will need scalenotomy or sclenectomy in addition to removal of the cause. This chapter explores the developmental and morphological aspects of a cervical rib. It also discusses its epidemiology, pathological features, etiology, clinical picture, imaging studies, differential diagnosis, and treatment. This chapter also addresses the clinical presentation, workup, and management of the neurogenic, arterial, and venous types of thoracic outlet syndrome.

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  1. Department of Surgery, Faculty of Medicine, Alexandria University, Alexandria, Egypt

    Mahmoud Sakr

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Sakr, M. (2023). Solid Swellings of the Posterior Triangle: Cervical Ribs. In: Lateral Neck Swellings. Springer, Cham. https://doi.org/10.1007/978-3-031-32118-4_15

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