TITLE:
Costoclavicular Syndrome and MRI Evaluation, Our Experience at Tertiary Care Hospital, SKIMS Srinagar, J&K
AUTHORS:
Shahnawaz Mansoor Shah, Imran Mansoor Shah, Zafar Ahmad Anim, Perveez Ahmad Malik
KEYWORDS:
Costoclavicular Compression Syndrome, MR Angio, Vascular Thoracic Outlet Syndrome, Neurogenic Thoracic Outlet Syndrome, Subclavian Artery Compression, MRI
JOURNAL NAME:
Surgical Science,
Vol.7 No.7,
July
5,
2016
ABSTRACT: Introduction:
Cervical rib is a supernumerary rib springing from one of the cervical
vertebrae, usually the seventh. About 1 in 200 people are born with cervical
rib. About 1 in 10 people who have a cervical rib develop symptoms of thoracic
outlet syndrome (TOS). Aims: The aim of this study was to identify normal and
abnormal anatomy of thoracic outlet using MRI in symptomatic costoclavicular
compression syndrome and to plan them for surgery thereafter. Methods: This was
a prospective hospital based study. All the symptomatic cases of cervical rib
syndrome admitted in the department of Cardiovascular and thoracic surgery
SKIMS, Srinagar from May 2011 to May 2015 were taken up for the study. Results:
A total of 40 cases of symptomatic cervical rib syndrome were reported from May
2011 to May 2015. Mean age of presentation was 26.3. The most prevalent age
group was 21 - 30 years (47%). Majority of patients were females (83%) with
male female ratio of 1:5. 67% had bilateral cervical rib, more in females (72%)
than males (40%). 97% had neurogenic thoracic outlet syndrome and 3% had
vascular thoracic outlet syndrome. 35% of cases with neurogenic thoracic outlet
syndrome had subclavian artery compression on MR Angio of thoracic outlet after
subjecting them to postural maneuvers. All the patients with subclavian artery
compression were subjected to surgery. Conclusion: Costoclavicular compression
syndrome affects mainly young females. MR Angio is
complementary in finding vascular compression in cases presenting mainly with
neurogenic symptoms of thoracic outlet syndrome.