Upward dislocation of the first rib: a rare cause of nerve entrapment, producing brachialgia

McCormick, C. C.; Gubbay, S S; Lekias, J. S.

doi:10.1259/0007-1285-54-638-140

Cited by 5 publications

(5 citation statements)

References 10 publications

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“…Superior subluxation of the first rib has been reported to be visible on X-rays (25,37), computerized tomography (CT) scans (25), and by cineradiography (19,22). McCormick et al (25) have reported a case that was visible on a CT scan, A-P radiographs, and cranially projected A-P radiographs. They reported that projecting the X-ray beam 20" cranially made the asymmetry more visible.…”

Section: Signs and Symptomsmentioning

confidence: 99%

“…They reported that projecting the X-ray beam 20" cranially made the asymmetry more visible. The reader should be aware that McCormick et al (25) describe this as superior "dislocation" of the first rib.…”

Section: Signs and Symptomsmentioning

confidence: 99%

“…These include other causes of TOS such as cervical rib, hyperabduction, scalene anticus, costoclavicular compression, fractured clavicle, pectoralis minor, and scalene minimus syndromes (1,31). In addition, nerve root compression by herniated discs, osteophytes, or lung neoplasm should be ruled out (25). Detailed discussion of the diagnostic criteria of the above syndromes is beyond the scope of this paper.…”

Section: Differential Diagnosismentioning

confidence: 99%

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Conservative Management of Superior Subluxation of the First Rib

Kamkar¹,

Cardi-Laurent²,

Whitney³

1992

Journal of Sport Rehabilitation

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Section: Signs and Symptomsmentioning

confidence: 99%

Section: Signs and Symptomsmentioning

confidence: 99%

Section: Differential Diagnosismentioning

confidence: 99%

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Conservative Management of Superior Subluxation of the First Rib

Kamkar¹,

Cardi-Laurent²,

Whitney³

1992

Journal of Sport Rehabilitation

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“…However, a case of atraumatic R1 dislocation causing brachial plexopathy has been successfully treated with surgical resection of the head and neck of R1. 7 We present a case or R1 dislocation within a review of eight similar cases, a challenging radiological diagnosis. A high degree of clinical and radiological suspicion for this injury is required in multi-trauma cases; awareness of related injuries will improve detection and facilitate prompt treatment.…”

mentioning

confidence: 98%

“…Although direct trauma is the most likely aetiology, the R1 dislocation might be a contributor; there is one previous case of superior R1 dislocation causing compressive brachial plexopathy. 7 Given the close anatomical proximity, detection of an R1 displacement should prompt a thorough neurological examination of the brachial plexus.…”

mentioning

confidence: 99%

Traumatic dislocation of the first rib: A case report and review of the literature

Stoddart

Handy

Cleland

et al. 2017

Emerg Medicine Australasia

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Left fourth and sixth costovertebral dislocation abutting the aorta

et al. 2023

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While rib fractures are common in blunt thoracic trauma, dislocations of the costovertebral joints (CVJs) are extremely rare and typically involve the first, eleventh, or twelfth rib. We report a rare case of dislocation of the left fourth and sixth CVJs in a 36-year-old man who was run over by a car. The rib heads were displaced anteriorly, abutting the aorta. Additional injuries included bilateral hemopneumothoraces, pneumomediastinum, pulmonary contusions, grade 3 splenic injury, left adrenal hematoma, retroperitoneal hematoma, Morel-Lavallée lesions at bilateral hips, and multiple fractures, including at the ribs and pelvis. There was also a fracture of the fourth thoracic vertebral body, which was occult on initial CT, but seen on subsequent CTs. The CVJ dislocations were managed conservatively, without short-term complications. Prompt surgical intervention has been recommended in cases where sharp rib fracture fragments are displaced close to the aorta to prevent fatal aortic injuries. However, there is a literature gap on the management of rib heads that are dislocated against the aorta. Our experience suggests that conservative management may be acceptable in some of these cases. This case report aims to increase radiologists’ awareness of CVJ injuries, which are important for thoracic spine stability, and highlights the association between CVJ dislocations and spinal injuries.

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Upward dislocation of the first rib: a rare cause of nerve entrapment, producing brachialgia

Cited by 5 publications

References 10 publications

Conservative Management of Superior Subluxation of the First Rib

Conservative Management of Superior Subluxation of the First Rib

Traumatic dislocation of the first rib: A case report and review of the literature

Left fourth and sixth costovertebral dislocation abutting the aorta

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