Extra first rib
![Extra first rib](/sites/default/files/styles/figure_image_teaser_large/public/figure_image/2018-08/0000001866/000001.jpg?itok=bCTc0sZ8)
Cardiovascular
Case TypeClinical Cases
AuthorsM. Celestre, C. Miglio, D. Marin, P. Paolantonio, R. Passariello
Patient29 years, female
The pain had been present for several years, but it had worsened in intensity and frequency in the months prior to presentation.
The patient underwent a plain film of the chest which demonstrated the presence of an extra first left rib. MR-angiography of the left subclavian artery and the aortic branches was performed with the left arm in adduction and then with the arm in abduction on a 1.5T magnet (Magnetom vision plus, Siemens, Erlange, Germany) equipped with a phased-array coil. 3D GRE T1-weighted images were acquired after injection of Gd-DTPA. Post-processing included MIP reconstruction performed on the main console.
The symptoms can mimic many other conditions, such as a herniated disk in the spine neck, carpal tunnel syndrome, and even bursitis of the shoulder. Investigations should include chest radiography to rule out cervical ribs or other bone anomalies.
Conventional angiography is usually performed when surgical intervention is considered in order to confirm the extrinsic compression of the artery. MR angiography is a non-invasive approach and doesn't require ionising radiation or iodinated contrast material administration. It allows a good evaluation of the subclavian artery in both adducted and abducted positions of the arm.
URL: | https://eurorad.org/case/1866 |
DOI: | 10.1594/EURORAD/CASE.1866 |
ISSN: | 1563-4086 |