DIFFERENTIAL DIAGNOSIS IN NECK SYMPTOMATOLOGY: CERVICAL RIB

Material and Methods: Patients who applied to the ear-nose-throat outpatient clinic of a tertiary hospital between January 2013 and January 2019 were retrospectively scanned according to the "International Statistical Classification of Diseases and Related Health Problems 10th Revision Version: 2010 (ICD-10)" code. Patients with the following diagnosis codes were included in the study: "M54.2-Neck pain", "R22.1-Localized swelling, mass, and lump of neck", "L02.1-Abbcess, furuncle, carbuncle of neck skin", "L04.0-Acute lymphadenitis; face, head, and neck", "C77.0-Secondary malign neoplasm of lymph node located in head, face, and neck", and "C76.0-Malign neoplasm of head, face, and neck".

Results: CR was detected in 32 (2.1%) of 1494 patients who had an appropriate radiologic study. The mean age was 42.9 ± 14.6 years. There were 30 female patients, and 2 patients were male. Eleven (34.4%) patients applied with another complaint, and CR was detected incidentally. Five (15,6%) patients had mass (palpated with hands or swelling over collarbone) and 16 (50%) patients had pain (pain with neck movement, neck pain, neck and back pain, neck and arm pain, neck pain spread to ear and shoulder) complaints. CR was located on the right side in seven patients, the left side in five patients, and bilaterally in 20 patients.

Conclusion: CR has to be considered in the differential diagnosis of neck pain and supraclavicular mass. If CR is overlooked, especially in patients with supraclavicular mass, the risk of unnecessary fine needle aspiration biopsy-even a terrifying situation of an open biopsy-can result. For this reason, investigating with direct radiography and neck tomography is suggested in suspicious cases. Keywords : Cervical rib, neck pain, supraclavicular mass