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Case 35: Painful left arm

A 65 year old man is bought in by ambulance hypotensive after collapsing at home. His main complaint is back pain and he is too distressed to provide much more information.

1. What operation has she had?

Left first rib resection.

2. What syndrome did she suffer fom?

Thoracic outlet syndrome.

3. What anatomic abnormality predisposes to the syndrome?

A cervical rib or band.