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Floating ribs in left clavical area, pain on working out, breathing difficulty. Rib can cause damage ?

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My daughter is a 16 year old 6'4" basketball athlete. She has a floating rib in her left clavical area. It has been bothering her more lately, when she does weight training and conditioning for sports. She says the floating rib hurts when she's working out hard and breathing hard. Is the pain an indication that the rib will press into her circulation too much and eventually cause more damage??
Posted Tue, 8 May 2012 in Bones, Muscles and Joints
Answered by Dr. Rajinder Bajoria 19 hours later

Thanks for posting your query.

A cervical rib is an extra rib which arises from the seventh cervical vertebra. It is a congenital abnormality located or found above the normal first thoracic rib. A cervical rib is seen in only 1 in 500 of people or in even rarer cases. Occasionally individual may have two cervical ribs i.e. on both sides of neck.

The presence of a cervical rib may remain asymptomatic for long in some people or may cause variety of sign & symptoms in some patients depending upon size, location, direction and structure compressed.

It can cause a form of Thoracic outlet syndrome due to compression of the lower trunk of the brachial plexus, a nerve complex or subclavian artery.

Compression of the brachial plexus may be diagnosed or identified by weakness of the muscles in the limb or hand, near the base of the thumb.

Compression of the subclavian artery can be diagnosed by finding a positive Adson's sign on clinical examination, where the radial pulse in the arm is lost during abduction and external rotation of the shoulder.

She should have through clinical examination which will tell whether the nerve or artery are compressed at rest or during exercise and exertion.

Detailed investigation like CT /MRI will help in finding exact location & compression.

If sign & symptoms persists or increase and hampers routine work & excercise or makes quality of life suffer, surgical removal may be indicated.

Hope I have answered your question well to your satisfaction.

I will be available for follow up queries if any.

Above answer was peer-reviewed by
Follow-up: Floating ribs in left clavical area, pain on working out, breathing difficulty. Rib can cause damage ? 3 hours later
Thank you. As I read your answer, I remembered that she also mentions numbness in her left arm when running. And, she regularly has back aches, but I always thought this was probably just the running on hard wood basketball courts. Maybe it all has to do with the cervical rib. She has had it examined a couple of years ago, but can it float or shift over time? The doctor also suggested removal, but there is possibility of loss of muscle or feeling in her arm/shoulder. Not a very good outcome for playing basketball! I guess my main concern is if this is something that could cause a stroke or heart attack if it is pressing on a main artery?

Answered by Dr. Rajinder Bajoria 14 hours later
Hello ,

Nice to hear from you again.

Cervical rib can cause numbness in the arm due to compression of nerves or nerve fibers on the side of cervical rib.

It don`t cause lower backache ,but pain in the upper part of back ,shoulder & neck can occur due to cervical rib.

Cervical rib never floats or shifts as it is fixed at one end to cervical vertebrae ,only minor movement of distal end can occur during exercise or strenous movement.

Post surgical removal some complication can occur even in the best hands & institutions,but the chances of complication in good hands is not more than 2-3%.

If every thing goes well & good neurosurgeon operates it ,one can easily play basket ball after surgery.

There is no chance of heart attacks and chances of stroke are also very rare ,as before that sign & symptoms becomes so severe ,that one gets it treated.

Complication of surgery are not more than long term problem of cervical rib.

Hope I have answered your question well to your satisfaction. Wish you speedy complete recovery at the earliest.
Above answer was peer-reviewed by
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