Rare Diseases Symptoms Automatic Extraction
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Regrown first rib in patients with recurrent thoracic outlet syndrome.
[thoracic outlet syndrome]
Recurrent
symptoms
of
thoracic
outlet
syndrome
(
TOS
)
after
first
rib
resection
have
varying
etiologies
.
Regrowth
of
a
first
rib
is
a
rare
event
.
Recurrent
symptoms
in
the
presence
of
a
regrown
rib
strongly
suggest
a
causal
relationship
.
We
report
our
experience
with
recurrent
symptoms
of
TOS
and
regrown
first
ribs
.
We
identified
patients
with
recurrent
TOS
symptoms
and
regrown
first
ribs
presented
between
1995
and
2012
.
Details
regarding
their
presentation
,
evaluation
,
and
treatment
were
gathered
.
Eight
patients
(
6
women
and
2
men
)
presenting
with
recurrent
TOS
symptoms
and
regrown
first
ribs
underwent
10
decompression
surgeries
.
Prior
surgeries
included
supraclavicular
first
rib
resection
(
5
)
,
transaxillary
first
rib
resection
(
5
)
,
scalenectomy
(
5
)
,
cervical
rib
resection
(
1
)
.
The
average
period
between
initial
surgery
and
reoperation
was
4
.
7
years
.
Average
age
at
current
presentation
was
40
.
8
years
(
range
29
-
52
)
.
All
patients
(
8
)
represented
with
neurogenic
symptoms
and
1
patient
with
concomitant
venous
TOS
symptoms
.
Presenting
symptoms
included
pain
(
8
)
,
numbness
and
tingling
(
7
)
,
weakness
(
6
)
,
headache
(
2
)
,
and
venous
congestion
(
3
)
.
Initial
treatment
included
physical
therapy
in
all
.
Preoperative
assessment
included
chest
X-
rays
(
8
)
,
magnetic
resonance
imaging
(
7
)
,
electrodiagnostic
studies
(
8
)
,
venography
(
2
)
,
and
anterior
scalene
muscle
block
(
2
)
.
Surgical
approach
included
transaxillary
resection
of
the
regrown
first
rib
(
10
)
,
neurolysis
of
brachial
plexus
(
10
)
,
scalenectomy
(
5
)
,
and
lysis
of
subclavian
vein
(
1
)
.
After
an
average
follow-up
of
10
.
8
months
,
resolution
of
symptoms
included
4
complete
and
4
partial
.
Regrowth
of
the
first
rib
is
a
rare
event
.
There
is
a
concordance
between
a
regrown
rib
and
TOS
symptoms
.
Patients
presenting
with
recurrent
TOS
symptoms
and
a
regrown
first
rib
have
a
high
probability
of
improvement
with
resection
of
the
regrown
rib
.
Diseases
Validation
Diseases presenting
"weakness"
symptom
achondroplasia
adrenomyeloneuropathy
alexander disease
aniridia
aromatase deficiency
coats disease
congenital toxoplasmosis
epidermolysis bullosa simplex
esophageal adenocarcinoma
familial hypocalciuric hypercalcemia
familial mediterranean fever
focal myositis
gm1 gangliosidosis
hydrocephalus with stenosis of the aqueduct of sylvius
inclusion body myositis
locked-in syndrome
lymphangioleiomyomatosis
malignant atrophic papulosis
neuralgic amyotrophy
pendred syndrome
pleomorphic liposarcoma
pyomyositis
pyruvate dehydrogenase deficiency
sneddon syndrome
systemic capillary leak syndrome
thoracic outlet syndrome
triple a syndrome
typhoid
von hippel-lindau disease
waldenström macroglobulinemia
werner syndrome
x-linked adrenoleukodystrophy
This symptom has already been validated
