Cervical Rib: A Retrospective Radiological Study on Morphological Features, Incidental Findings, and Clinical Correlation

Background: Cervical ribs are rare congenital anomalies that may be asymptomatic or associated with neurovascular complications due to compression of the thoracic outlet. This study evaluates the incidence, morphological types, and clinical relevance of cervical ribs identified incidentally in chest radiographs. Materials and Methods: A retrospective observational study was conducted using 1000 chest radiographs collected from the Department of Radiology, Osmania Medical College, and Hyderabad. Radiographs from both sexes aged 12–80 years were reviewed for the presence and morphology of cervical ribs. Cases with rib fractures, incorrect positioning, or associated anomalies were excluded. Results: Cervical ribs were detected in 15 (1.5%) radiographs. The incidence was higher in females (2.5%) compared to males (0.92%). Bilateral cervical ribs were observed exclusively in females. Most cervical ribs were unilateral and located on the right side. Several patients presented with upper limb neurological symptoms suggestive of thoracic outlet syndrome (TOS), while others were asymptomatic. Conclusion: Cervical ribs, though often incidental, may be clinically significant when symptomatic, particularly in the presence of neurovascular compression. Recognition of cervical ribs in routine imaging is crucial for appropriate management of patients with thoracic outlet symptoms.