Cervical rib syndrome

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  1. Rare entity associated with upper extremity weakness (atrophy of the thenar eminence), arm pain (medial forearm), and cervical ribs
  2. Occurs typically in young and middle aged females
  3. Symptoms due to compressive fibrous band, continuous with the medial edge of the scalenus medius (middle scalene muscle); band extends from the rib or elongated transverse process of C7 to the first rib and compresses the lower portion of the brachial plexus
  4. Treatment: surgery through supraclavicular incision with dissection down to the plexus and retraction on the omohyoid; subclavian artery is elevated and compressive band is cut
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