Work

Congenital first and second rib fusion causing neurogenic thoracic outlet syndrome in an adolescent

Year: 2026

Type: article

Abstract: A 14-year-old girl presented with progressive right-sided neck and shoulder pain and ulnar-distribution paresthesia, consistent with neurogenic thoracic outlet syndrome. Computed tomography imaging revealed congenital fusion of the right first and second ribs causing brachial plexus compression. Conservative therapy was ineffective, and she underwent a transaxillary resection of the fused right first and second ribs with anterior scalenectomy. Intraoperatively, dense periosteal scarring and brachial plexus entrapment were identified. Symptoms fully resolved postoperatively. Congenital first-second rib synostosis is an exceptionally rare cause of pediatric neurogenic thoracic outlet syndrome. Early recognition and surgical decompression can prevent chronic disability and restore normal function.

Source: Journal of Vascular Surgery Cases and Innovative Techniques

DOI: 10.1016/j.jvscit.2026.102178

Authors: Daiven S. Sharma, Ulugbek Negmadjanov, Kevin Z. Chang

Institutions: Atrium Health Wake Forest Baptist, University of Arkansas Medical Center

Language: English

Topic: Peripheral Nerve Disorders

Subfield: Radiology, Nuclear Medicine and Imaging

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $1,250