The subclavius posticus muscle: a factor in arterial, venous or brachial plexus compression?

During dissection practice in 1993 and 1995 to 1999, we found an aberrant muscle which connected the first costal cartilage and the superior margin of the scapula in 12 sides (4.8%) of 11 cadavers (8.9%) among 248 sides of 124 cadavers. The muscle originated from the cranial surface of the sternal end of the first rib, ran laterodorsally, and inserted into the superior margin of the scapula. According to the origin and insertion, the aberrant muscle was considered to be the subclavius posticus (Rosenmüller, 1800). We also examined the supraclavicular region of a living subject by MR imaging to estimate the course of such an aberrant muscle. It is thought that the aberrant muscle runs on the anterior surface of the subclavian vein and crosses over the brachial plexus. Such a muscle could be considered as a possible factor causing the Paget-von Schrötter syndrome which is recognized as spontaneous or effort-related thrombosis of the axillo-subclavian vein. It is recommended to take into account the possible existence of such an aberrant muscle during the examination of patients with thoracic outlet syndrome, especially in those with symptoms of venous compression.