cervical rib syndrome
Introduction
Introduction to cervical rib syndrome Neck ribs are ubiquitous in fish and reptiles, and have been degraded in humans. The neck rib is the name of an abnormal anatomical structure in the human body. It is generally considered to be one of the most common causes of thoracic outlet syndrome. Not all symptoms, but when there are symptoms of cervical ribs, it should be considered a disease, namely cervical rib syndrome. Cervical rib syndrome rarely occurs in people under the age of 30. basic knowledge The proportion of illness: 0.005% Susceptible people: women who are born after 40 years old Mode of infection: non-infectious Complications: swelling
Cause
Causes of cervical rib syndrome
For the cause of this disease, Chinese medicine and Western medicine have their own views:
1. Chinese medicine
The Chinese medicine understanding of this disease is roughly the same as that of the anterior scalene muscle syndrome. The congenital endowment is insufficient. The cervical spine malformation is a prerequisite for the occurrence of this disease. In addition, it is the internal cause of the disease, such as liver and kidney weakness, muscle weakness and weakness. Disease, the etiology and pathogenesis of this disease should be recognized from the following two aspects.
(1) qi and blood stasis: congenital people with neck ribs, due to strain of neck and shoulder muscles, or long-term labor, can lead to local venous qi and blood stasis, muscles dying and causing pain.
(2) Liver and kidney deficiency: people with congenital deficiency and neck ribs, lack of function of liver and kidney sputum, leading to liver and kidney weakness, atrophy of bones and muscles, most of these patients feel cold, cold and external evil, obstructing meridians, making symptoms worse. .
2, Western medicine
The cervical rib is a deformed rib from the seventh cervical vertebrae, which can be bilateral. The distal end is connected by a fiber band to the first rib. The presence of the cervical rib will cause the brachial plexus and the subclavian artery to rise, reducing the thoracic outlet and increasing the blood vessel. The clinical symptoms are caused by the distraction of the nerve. If there is a scapula with a sagging, a high sternum, the first rib is more obvious, and the neck rib is not symptomatic. This disease rarely occurs in people under 30 years old.
Prevention
Cervical rib syndrome prevention
The disease is a congenital disease, no effective preventive measures, early diagnosis and early treatment is the key to the prevention and treatment of this disease, but it should be noted that people who do not have cervical ribs will have symptoms, first of all should choose conservative treatment, conservative treatment if no effect, then take Surgical treatment to avoid unnecessary damage to the patient.
Complication
Complications of cervical rib syndrome Complications swelling
In the severe case, the three lower nerve trunks can be involved. The symptoms of vascular involvement are repeated swelling of the hands and fingers, cold, pale, cyanosis and tingling. In very severe cases, finger gangrene can occur. When the blood vessels are involved, the subclavian artery is often compressed, the radial artery is temporarily blocked, and the upper part of the subclavian artery is increased in pulsation and murmur.
Symptom
Symptoms of cervical rib syndrome Common symptoms Arm pain upper limbs and shoulders down... Hand weakness and unconscious... Hairless side rib pain Allergic neck hard fatigue shoulder pain
1, symptoms:
(1) Women who are born after the age of 40 have more right side than left side.
(2) neck discomfort, toughness, neck and shoulder pain, and radiation to the elbow joint, the forearm ulnar side, the 4 fingers and 5 fingers of the hand, the pain accompanied by numbness, severe pain during the day, relief at rest, when raising the upper limb Pain disappears or is relieved; pain is exacerbated by pulling the upper limb down.
(3) The elbow work is easy to fatigue, the hand is weak, and the object is unconsciously thrown away.
(4) Repeated swelling of the hands and fingers, cold, pale, cyanosis or numbness, vascular involvement, extremely severe gangrene between the fingers, sometimes sympathetic symptoms and vascular symptoms are not easy to distinguish.
2, signs
(1) The neck base is tender and the cervical vertebra activity is limited.
(2) Pressurization in the neck ribs can lead to local tenderness and radiation pain.
(3) In the supraclavicular area, the full beat can be touched and a tender mass can be reached. The murmur can be heard in the subclavian artery. The patient's hand is cold, the radial artery beats weakly or even disappears, the skin is bright, and the nail is broken. Ulcers occur in the crack or between the fingers. In severe cases, there are motor symptoms, weakness in the hands, muscle atrophy and shaking of the internal muscles of the hands.
(4) When the ulnar nerve is compressed, the 4th and 5th fingers are hypersensitive and have interosseous muscles. The small intermuscular muscles and the female adductor muscles are atrophied. The median nerve is affected by the large intermuscular muscle atrophy, sometimes the second and third triceps. Decreased with periosteal reflex and the like.
Examine
Examination of cervical rib syndrome
The auxiliary examination method for this disease is mainly X-ray examination: about 0.5%-1.0% of the population has neck ribs, about half of them are bilateral: more common in women, neck ribs are on the sides of the seventh cervical vertebra or ribs on one side Sometimes, the symptoms of brachial plexus compression may occur. The whole cervical vertebra or the entire thoracic vertebrae are included in the film. The neck ribs are often short and thin, sometimes blending with the transverse process, and the edges are not neat, but the neck ribs can also be shaped. Such as the normal first rib; such as the two sides of the ribs, the length of the sides, the thickness is often asymmetrical.
Diagnosis
Diagnosis and differentiation of cervical rib syndrome
Cervical rib syndrome occurs more than 30 years old, and its condition is similar to that of cervical spondylosis. The symptoms are somewhat similar and need to be identified clinically. In addition, the scapula sag is high, the sternum is high, the first rib is high, and the lower brachial plexus and anterior oblique angle Muscle hypertrophy can cause symptoms similar to cervical ribs, because they both compress the brachial plexus and the subclavian artery to produce symptoms, and must be strictly identified in clinical diagnosis. Other diseases that need to be identified include: neck Disc herniation, rib lock syndrome, excessive abduction syndrome, medullary cavity, spinal cord tumor, ulnar nerve carpal tunnel syndrome, Raynaud's disease.
