Images in Clinical Rheumatology
Double Cervical Rib: A Case Report
Doble costilla cervical: a propósito de un caso
Nahia Plaza Aulestia
, Sergio Rodríguez Montero, María Luisa Velloso Feijoo
Corresponding author
Servicio de Reumatología, Hospital Universitario Virgen de Valme, Sevilla, Spain
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"Tamanyo" => 57683 ] ] "descripcion" => array:1 [ "es" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Costilla cervical proximal (flecha fina) que se origina en el cuerpo vertebral C3 (estrella) dirigiéndose hacia caudal y se articula con otra costilla supernumeraria distal (flecha gruesa) con trayectoria ascendente, que parte desde el cuerpo vertebral C7 (punta de flecha).</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Nahia Plaza Aulestia, Sergio Rodríguez Montero, María Luisa Velloso Feijoo" "autores" => array:3 [ 0 => array:2 [ "nombre" => "Nahia" "apellidos" => "Plaza Aulestia" ] 1 => array:2 [ "nombre" => "Sergio" "apellidos" => "Rodríguez Montero" ] 2 => array:2 [ "nombre" => "María Luisa" "apellidos" => "Velloso Feijoo" ] ] ] ] ] "idiomaDefecto" => "es" "Traduccion" => array:1 [ "en" => array:9 [ "pii" => "S2173574318301436" "doi" => "10.1016/j.reumae.2018.10.009" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => 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He also reported neck pain limiting movement, of one month's onset.</p><p id="par0010" class="elsevierStylePara elsevierViewall">Joint examination highlighted synovitis 1st left MCP, 2nd to 4th left PIP, 2nd to 3rd right MCP and 2nd to 4th right PIP. Pain with no swelling 2nd to 4th left MCP. Painful hips, knees and shoulders, with no functional limitation and positive SI opening and closing manoeuvres. Laboratory tests showed slightly increased acute phase reactants (CRP 17.9 and ESR 18), with no other pathological findings, and negative RF, ANA and ANCA.</p><p id="par0015" class="elsevierStylePara elsevierViewall">The plain neck X-ray (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>) performed on admission showed a proximal cervical rib originating in vertebral body C3 in a caudal direction and articulating with another distal supernumerary rib, originating and ascending from vertebral body C7.</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Discussion</span><p id="par0020" class="elsevierStylePara elsevierViewall">Cervical ribs are prolongations of the transverse process of the seventh cervical vertebra beyond the transverse process of the first thoracic rib. Their incidence is different in different countries,<a class="elsevierStyleCrossRefs" href="#bib0045"><span class="elsevierStyleSup">1–7</span></a> although it is estimated at around between .2% and 8%, and is more common in women.<a class="elsevierStyleCrossRefs" href="#bib0055"><span class="elsevierStyleSup">3,5,7</span></a> They can be unilateral or bilateral (the latter comprise 50%–80%), with poor right predominance when they are unilateral.<a class="elsevierStyleCrossRefs" href="#bib0050"><span class="elsevierStyleSup">2,8</span></a> In 90% of cases they tend to be asymptomatic<a class="elsevierStyleCrossRefs" href="#bib0055"><span class="elsevierStyleSup">3,6–8</span></a> and are usually diagnosed accidentally when a plain X-ray of the chest or cervical spine is performed for a different reason. Treatment is usually conservative with rehabilitation, except when symptoms occur caused by nerve (brachial plexus) or vascular (subclavian artery) compression,<a class="elsevierStyleCrossRefs" href="#bib0065"><span class="elsevierStyleSup">5–7</span></a> when the surgical option is taken.<a class="elsevierStyleCrossRef" href="#bib0060"><span class="elsevierStyleSup">4</span></a></p></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Ethical Responsibilities</span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Protection of people and animals</span><p id="par0025" class="elsevierStylePara elsevierViewall">The authors declare that no experiments were performed on humans or animals for this investigation.</p></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Data confidentiality</span><p id="par0030" class="elsevierStylePara elsevierViewall">The authors declare that they have followed the protocols of their work centre on the publication of patient data.</p></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0030">Right to privacy and informed consent</span><p id="par0035" class="elsevierStylePara elsevierViewall">The authors declare that no patient data appears in this article.</p></span></span><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Conflict of Interests</span><p id="par0040" class="elsevierStylePara elsevierViewall">The authors have no conflicts of interests to declare.</p></span></span>" "textoCompletoSecciones" => array:1 [ "secciones" => array:5 [ 0 => array:2 [ "identificador" => "sec0005" "titulo" => "Presentation of the Case" ] 1 => array:2 [ "identificador" => "sec0010" "titulo" => "Discussion" ] 2 => array:3 [ "identificador" => "sec0015" "titulo" => "Ethical Responsibilities" "secciones" => array:3 [ 0 => array:2 [ "identificador" => "sec0020" "titulo" => "Protection of people and animals" ] 1 => array:2 [ "identificador" => "sec0025" "titulo" => "Data confidentiality" ] 2 => array:2 [ "identificador" => "sec0030" "titulo" => "Right to privacy and informed consent" ] ] ] 3 => array:2 [ "identificador" => "sec0035" "titulo" => "Conflict of Interests" ] 4 => array:1 [ "titulo" => "References" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2017-06-26" "fechaAceptado" => "2017-06-27" "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as: Plaza Aulestia N, Rodríguez Montero S, Velloso Feijoo ML. Doble costilla cervical: a propósito de un caso. Reumatol Clin. 2019;15:370–371.</p>" ] ] "multimedia" => array:1 [ 0 => array:7 [ "identificador" => "fig0005" "etiqueta" => "Fig. 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1048 "Ancho" => 900 "Tamanyo" => 57790 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Proximal cervical rib (thin arrow) originating in vertebral body C3 (star) in a caudal direction and articulating with another distal supernumerary rib (thick arrow) originating and ascending from vertebral body C7 (arrow tip).</p>" ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0015" "bibliografiaReferencia" => array:8 [ 0 => array:3 [ "identificador" => "bib0045" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Analysis of cervical ribs in a series of human fetuses" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "J. 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| Year/Month | Html | Total | |
|---|---|---|---|
| 2024 November | 3 | 9 | 12 |
| 2024 October | 67 | 41 | 108 |
| 2024 September | 80 | 32 | 112 |
| 2024 August | 77 | 56 | 133 |
| 2024 July | 83 | 32 | 115 |
| 2024 June | 89 | 34 | 123 |
| 2024 May | 82 | 28 | 110 |
| 2024 April | 85 | 32 | 117 |
| 2024 March | 97 | 32 | 129 |
| 2024 February | 85 | 36 | 121 |
| 2024 January | 82 | 28 | 110 |
| 2023 December | 69 | 21 | 90 |
| 2023 November | 78 | 42 | 120 |
| 2023 October | 80 | 26 | 106 |
| 2023 September | 108 | 35 | 143 |
| 2023 August | 76 | 14 | 90 |
| 2023 July | 63 | 20 | 83 |
| 2023 June | 59 | 26 | 85 |
| 2023 May | 88 | 24 | 112 |
| 2023 April | 83 | 8 | 91 |
| 2023 March | 83 | 24 | 107 |
| 2023 February | 92 | 23 | 115 |
| 2023 January | 99 | 27 | 126 |
| 2022 December | 97 | 18 | 115 |
| 2022 November | 93 | 26 | 119 |
| 2022 October | 105 | 40 | 145 |
| 2022 September | 100 | 31 | 131 |
| 2022 August | 115 | 47 | 162 |
| 2022 July | 115 | 38 | 153 |
| 2022 June | 77 | 34 | 111 |
| 2022 May | 66 | 35 | 101 |
| 2022 April | 89 | 36 | 125 |
| 2022 March | 107 | 40 | 147 |
| 2022 February | 117 | 26 | 143 |
| 2022 January | 189 | 34 | 223 |
| 2021 December | 168 | 47 | 215 |
| 2021 November | 275 | 50 | 325 |
| 2021 October | 153 | 48 | 201 |
| 2021 September | 122 | 40 | 162 |
| 2021 August | 100 | 28 | 128 |
| 2021 July | 113 | 26 | 139 |
| 2021 June | 86 | 26 | 112 |
| 2021 May | 104 | 43 | 147 |
| 2021 April | 328 | 105 | 433 |
| 2021 March | 157 | 30 | 187 |
| 2021 February | 118 | 26 | 144 |
| 2021 January | 89 | 22 | 111 |
| 2020 December | 89 | 14 | 103 |
| 2020 November | 85 | 21 | 106 |
| 2020 October | 59 | 17 | 76 |
| 2020 September | 115 | 19 | 134 |
| 2020 August | 86 | 18 | 104 |
| 2020 July | 72 | 17 | 89 |
| 2020 June | 30 | 15 | 45 |
| 2020 May | 24 | 18 | 42 |
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