National Center for Advancing and Translational Sciences Genetic and Rare Diseases Information Center, a program of the National Center for Advancing and Translational Sciences

Thoracic outlet syndromes



I had arterial thoracic outlet syndrome (TOS) caused by having an additional cervical rib.  I had cervical and 1st rib resection on the right and left. My Question: It's not common to have an extra cervical rib. Can my children have a higher chance of also having this rib which could lead to TOS for them?

Cervical ribs are actually thought to be a common trait. It has been estimated that 1 to 2% of the population have a cervical rib.[1] Cervical ribs can affect one or both sides of the neck, and may cause thoracic outlet syndrome by putting pressure on an artery.[2] 

Currently, the cause of cervical ribs is not known. In general, both genetic and environmental factors are thought to be involved. There have been animal studies investigating the role of HOX genes in causing extra ribs.[3] Studies have also suggested environmental exposures, such as maternal exposure to foreign chemicals or stress during pregnancy could play a role.[4] Further research in this area is needed. There have been rare case reports of families with multiple members with cervical rib. In these families autosomal dominant inheritance was suspected.[5] Click here to learn more about autosomal dominant inheritance.  

While we were unable to find recurrence risk data that might help inform your loved ones of their risk for cervical rib and thoracic outlet syndrome, we do suggest that your family members let their healthcare provider know of their family medical history. The Surgeon General's Family History Initiative's Family Health Portrait Tool, may be a helpful resource. You can use this tool to collect, record, and share your family health history information.
http://www.hhs.gov/familyhistory/

Last updated: 3/1/2013

We hope this information is helpful. We strongly recommend you discuss this information with your doctor. If you still have questions, please contact us.

Warm regards,
GARD Information Specialist

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  1. Cervial Rib. National Library of Medicine Medical Subject Headings. http://www.nlm.nih.gov/cgi/mesh/2013/MB_cgi?mode=&index=25406&view=expanded. Accessed 3/1/2013.
  2. Goshima K. Overview of thoracic outlet syndrome. In: Basow, DS (Ed). UpToDate. Waltham, MA: UpToDate; July 15, 2014; http://www.uptodate.com/contents/overview-of-thoracic-outlet-syndromes. Accessed 8/11/2015.
  3. Galis F. Why do almost all mammals have seven cervical vertebrae? Developmental constraints, Hox genes, and cancer. J Exp Zool. 1999 Apr 15;285(1):19-26; http://www.ncbi.nlm.nih.gov/pubmed/?term=10327647. Accessed 3/1/2013.
  4. Chernoff N, Rogers JM. Supernumerary ribs in developmental toxicity bioassays and in human populations: incidence and biological significance. J Toxicol Environ Health B Crit Rev. 2004 Nov-Dec;7(6):437-49; http://www.ncbi.nlm.nih.gov/pubmed/15586878. Accessed 3/1/2013.
  5. Online Mendelian Inheritance in Man. June 25, 1984; http://omim.org/entry/117900. Accessed 3/1/2013.