What does this research mean for the field?

Ultrasound-guided hydrodissection provides immediate and sustained symptom relief in a patient with neurogenic thoracic outlet syndrome caused by a cervical rib. Novelty: ClaimNovelty.NOVEL_FINDING. Consensus alignment: ConsensusAlignment.NEUTRAL.

What question did this study set out to answer?

This case report aims to present a unique treatment for neurogenic thoracic outlet syndrome caused by a cervical rib.

March 5, 2026Open Access

Ultrasound-Guided Hydrodissection for Neurogenic Thoracic Outlet Syndrome Caused by a Cervical Rib: A Case Report

Key Points

This case report aims to present a unique treatment for neurogenic thoracic outlet syndrome caused by a cervical rib.
Performed dynamic ultrasound examination to assess brachial plexus tethering.
Administered serial ultrasound-guided hydrodissection to the affected area.
Monitored symptom relief over a defined period.
Demonstrated immediate symptom relief following hydrodissection.
Provided sustained symptom relief in follow-up assessments.
Confirmed brachial plexus tethering as a contributing factor to symptoms.

Abstract

Thoracic outlet syndrome (TOS) is an underdiagnosed condition that is frequently misattributed to cervical spine pathology. Neurogenic TOS (nTOS), the most common subtype, often presents nonspecific upper extremity pain and paresthesia, making diagnosis challenging. We report a case of nTOS associated with a cervical rib that was successfully treated with ultrasound-guided hydrodissection (HD). Dynamic ultrasound examination demonstrated brachial plexus tethering with symptom reproduction. Serial HD resulted in immediate and sustained symptom relief, suggesting that this minimally invasive technique may represent a potential diagnostic adjunct and minimally invasive therapeutic option in carefully selected patients with cervical rib-associated nTOS.

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