Case presentation A 42-year-old woman presents to the vascular clinic with cramping pain and numbness in the left hand. This morning she noticed a black patch on the tip of her thumb and index finger. She is a heavy smoker and is on medication for hypertension. Examination The hand is warm and well-perfused, with a palpable radial pulse. Allen’s test is normal, and she has no upper limp neurological deficit.
A hard bony swelling is palpable in the supraclavicular fossa. It is not pulsatile and is immobile. A plain anterior-posterior x-ray of the lower cervical spine revealed a cervical rib. What do you recommend for relieving the symptoms? *This Case Challenge is from the Editorial Team of Docplexus and is meant for educational purposes only.
