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Updated: Aug 22, 2025

Transaxillary First Rib Resection for Treatment of the Thoracic Outlet Syndrome
Published on: September 13, 2020
[Entrapment syndromes of the intercostal nerve and its branches]
L Azcue Muñoz1, J Formigo Couceiro2, R Martín Mourelle2
1Servicio de Medicina Física y Rehabilitación, Complejo Hospitalario Universitario de Albacete, Albacete, España.
Abstract:
Musculoskeletal chest pain poses a broad differential diagnosis, among which intercostal nerve involvement stands out. Its entrapment or that of any of its branches can resemble visceral pain and therefore can easily go unnoticed. With a good examination and the use of dynamic ultrasound, the diagnostic approach can be simpler. We present a 40-year-old man evaluated in a rehabilitation department for right lower rib pain, triggered by certain movements and associated with a pectus excavatum type thoracic deformity. Using dynamic ultrasound maneuvers, he was diagnosed with neuralgia of the 7th right intercostal nerve secondary to dynamic entrapment in the context of a thoracic deformity with costal hypermobility. We describe the clinical presentation, ultrasound imaging, treatment, and evolution after treatment. In this case, we describe entrapment syndromes of the intercostal nerve and its branches, their clinical and ultrasound diagnosis, and their therapeutic approach.
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