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
"headache"
symptom
acute rheumatic fever
adrenal incidentaloma
allergic bronchopulmonary aspergillosis
cadasil
cushing syndrome
cutaneous mastocytosis
erdheim-chester disease
esophageal squamous cell carcinoma
familial mediterranean fever
hereditary cerebral hemorrhage with amyloidosis
hydrocephalus with stenosis of the aqueduct of sylvius
legionellosis
locked-in syndrome
malignant atrophic papulosis
scrub typhus
severe combined immunodeficiency
sneddon syndrome
systemic capillary leak syndrome
thoracic outlet syndrome
typhoid
von hippel-lindau disease
This symptom has already been validated
