Weekly Chest CasesArchive of Old Cases

Case No : 386 Date 2005-03-19

  • Courtesy of Yon Mi Sung, M.D., Tae Sung Kim, M.D. / Samsung Medical Center, Sungkyunkwan University, Seoul, Korea
  • Age/Sex 28 / M
  • Chief ComplaintTingling sensation on left hand (Symptom increases upon elevation of arm)
  • Figure 1
  • Figure 2

Diagnosis With Brief Discussion

Diagnosis
Thoracic outlet syndrome due to cervical rib
Radiologic Findings
A chest radiograph shows bilateral cervical rib. Upper extremity CT angiography before operation shows severe stenosis at the proximal segment of left subclavian artery. After resection of left cervical rib, CT angiography demonstrates improvement of that.
Brief Review
Definition: Compression of nerves, veins, and arteries between chest and arm

Cause
A. Congenital

i. Cervical rib

ii. Anterior scalene muscle

iii. Anomalous 1st rib

B. Acquired

i. Muscular body habitus

ii. Slender body habitus

iii. Fracture of clavicle / 1st rib

iv. Supraclavicular tumor / lymphadenopathy
References
Keywords
Rib, Congenital,

No. of Applicants : 53

▶ Correct Answer : 37/53,  69.8%
  • - Al-Hada Armed Forces Hospital, Saudi Arabia Ahmed Fathi Eid
  • - Annecy Hospital, France Gilles Genin
  • - Asan Medical Center, Korea Hyun Joo Kim
  • - ASL BOLOGNA Maggiore Hospital, Bologna, Italy Marcellino Burzi
  • - Busan Veterans Hospital, Korea Suhku Huh
  • - Centre d'imagerie Jacques Callot, Nancy, France Lionel Cannard
  • - CH Metz Nancy, France Blondel manuel
  • - CHU Besancon, France Sebastien Aubry
  • - CHU Besancon, France Puget Julien
  • - CIM Saint Dizier, France JC Leclerc
  • - Ev. Krkhs. Hubertus, Berlin, Germany Michael Weber
  • - Ewha Womans University Mokdong Hospital, Korea Yookyung Kim
  • - Good Gang-An Hospital, Korea Sang Hee Lee
  • - Gwangmyoung Sung-Ae Hospital, Korea Jiyong Rhee
  • - Hanyang University Hospital, Seoul, Korea Yo Won Choi
  • - Homs National Hospital, Homs, Syria Rami Abou Zalaf
  • - Hospital de la Marina Baixa, Villajoyosa, Spain Carlos F. Munoz-Nunez
  • - Ibra Hospital, Oman Shaker Abd el fadeel
  • - IRCCS S.Luca Hosp.-Milano- Italy Filippo Casolo
  • - Jankharia Imaging Bhavin Jankharia
  • - Jikei University of medicine, Japan Shigeki Misumi
  • - Jinju Jeil Hospital, Korea Hyung-Gon Lee
  • - Kyunghee university hospital, Seoul, Korea Su Youn Sim
  • - Max Hospital, Delhi, India Vickrant Malhotra
  • - MH (CTC) Pune, India Vivek Sharma
  • - Monaldi Hospital, Naples, Italy Gaetano Rea
  • - National Taiwan University Hospital, Taipei, Taiwan Bang-Bin Chen
  • - National Taiwan University Hospital, Taipei, Taiwan Chi-Kuei Hsu
  • - OBP, Russia Dasha Lepikhina
  • - Ping Tung Christian Hospital,Taiwan Jun-Jun Yeh
  • - Samsung Medical Cneter, Seoul, Korea Ha Young Kim
  • - Seoul National University Hospital, Korea Seung Hong Choi
  • - Seoul National University Hospital, Korea Dae Sik Kim
  • - Sharma Clinic, Jaipur, India Dinesh Sharma
  • - Shiga University of Medical Science, Shiga, Japan Yukihiro Nagatani
  • - Social Security Hospital, Ankara, Turkey Meric Tuzun
  • - Yon sei Univ. Hospital Korea Eun Hae Yu
▶ Semi-Correct Answer : 8/53,  15.1%
  • - Apollo Firstmed Hospitals, Chennai,India RG Gopinath
  • - Bundan Cha Hospital, Korea Kyung A Kim
  • - European Hospital, Paris, France Rached Triki
  • - Korea Hospital, Korea Jun Gil Cho
  • - Ross University, Portsmouth, Dominica Charles Ambelang
  • - Sweida National Hospital, Syria Marwan Al Chami
  • - University Hospital Ghent, Belgium Kristof De Cuyper
  • - Abograra Said
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