During the last half century scores of papers have been written on pain in the upper extremity, but it is evident that the problem today lacks satisfactory resolution. There is little doubt that in certain instances compression of the neurovascular structures in the neck is due to a cervical rib. Essentially the same symptoms may be present when there is no cervical rib, and numerous authors have believed that the scalenus anterior muscle plays a major role in the production of these symptoms. A review of recent literature indicates growing discord regarding compression of the brachial plexus due to displacement (scalenus anticus syndrome), and many dissent from the idea that the scalenus anterior syndrome without cervical rib is a definite factor in upper extremity pain.
In the past 16 years my associates and I have seen 117 patients whose symptoms and signs were such that a diagnosis of cervical rib
Raaf J. SURGERY FOR CERVICAL RIB AND SCALENUS ANTICUS SYNDROME. JAMA. 1955;157(3):219–223. doi:10.1001/jama.1955.02950200017005