The relationship between various anatomical landmarks used for localizing the first rib during surface palpation

Loyd, Brian J.; Gilbert, Kerry K.; Sizer, Phillip S.; Atkins, Lee T.; Sobczak, Stéphane; Brismée, Jean‐Michel; Pendergrass, Timothy

doi:10.1179/2042618613y.0000000064

Cited by 4 publications

(5 citation statements)

References 10 publications

(4 reference statements)

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“…In this study, palpation of first rib and assessment of accessory movements reached a strong consensus of being key aspects to identify the first rib dysfunction. The longitudinal caudad accessory movement claims to assess first rib passive mobility [26]; however, its reliability has been questioned when used for detecting passive stiffness of the first rib [27]. Loyd et al [26] suggested a method to locate the first rib that was valid, but only on a cadaver.…”

Section: Cervical Rotation Lateral Flexion Test-reliability/validitymentioning

confidence: 99%

“…The longitudinal caudad accessory movement claims to assess first rib passive mobility [26]; however, its reliability has been questioned when used for detecting passive stiffness of the first rib [27]. Loyd et al [26] suggested a method to locate the first rib that was valid, but only on a cadaver. More research is indicated to support the use of this procedure.…”

Section: Cervical Rotation Lateral Flexion Test-reliability/validitymentioning

confidence: 99%

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First rib dysfunction in patients with neck and shoulder pain: a Delphi investigation

Mastromarchi

May

2020

Journal of Manual & Manipulative Therapy

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Background: First rib dysfunction is a possible cause of symptoms in patients with neck and/or shoulder pain. Objectives: To explore therapists' perceptions of useful diagnostic criteria to identify first rib dysfunction. Methods: A Delphi survey over four rounds involving international manual therapy experts who were asked to agree on which items were most useful in identifying first rib dysfunction. Results: Consensus (>70% agreement) was reached on key aspects of first rib dysfunction being first rib mobility restriction, upper limb symptom distribution, and a subclassification into two subgroups was suggested. The main clinical findings suggested were: painful and restricted neck movements and shoulder girdle loading activities; positive Upper Limb Neural Test 1; direct palpation of first rib, neural structures, and scalene muscles; pain and hypomobility of first rib accessory movements with improvement after mobilization. The cervical rotation lateral-flexion test was considered a useful, although not widely used test among the experts. Its diagnostic accuracy and interpretation in isolation was questioned. Conclusions: This Delphi study produced a cluster of clinical tests aimed to identify first rib dysfunction in patients with neck and/or shoulder conditions. However, these need to be tested out in further research to establish reliability and validity.

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Section: Cervical Rotation Lateral Flexion Test-reliability/validitymentioning

confidence: 99%

Section: Cervical Rotation Lateral Flexion Test-reliability/validitymentioning

confidence: 99%

First rib dysfunction in patients with neck and shoulder pain: a Delphi investigation

Mastromarchi

May

2020

Journal of Manual & Manipulative Therapy

View full text Add to dashboard Cite

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“…The examination is repeated for the contralateral side and also for D2. To successfully evaluate the cost-transverse joint, a line branching off perpendicularly from the mastoid process towards the rib tubercle has to be imaged; the joint is located medially to this line [38]. This joint can generate pain, thanks to the presence of neuropeptides which communicate with the somatic and autonomic system (Substance P, calcitonin-gene-related peptide, neuropeptide Y) [39].…”

Section: First Phase: the Patient Standingmentioning

confidence: 99%

“…Once the first rib is detected by using thumbs, the rib must be pushed caudally pushing, to verify its elasticity; otherwise, always by using thumbs, the operator can verify if one rib is more raised than the contralateral one in inspiration, by asking for deep inspirations (the first rib raised), and expirations (the first rib lowers) [38]. The movement is known as the bucket handle [37] [38]. A positional alteration is a frequent cause of TOS [38].…”

Section: The Third Phase: the Patient Being Supinementioning

confidence: 99%

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New Proposal of Evaluation of the Thoracic Outlet

Bordoni¹,

Marelli²,

Bruno³

et al. 2018

OJTR

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The present article comprehensively reviews the thoracic outlet syndrome (TOS), its etiology and assessment, with reference to the usual conservative treatment and surgical therapy, highlighting new definitions and reporting obsolete tests. The syndrome affects about 8% of the population, with higher prevalence in females, and rarely affects the children. Conservative, non-surgical treatment produces good results, and it becomes important to know which specific areas need to be treated. Currently, there is no rehabilitation scheme, either osteopathic or chiropractic, considered as a valid tool for a precise localization of the pathologic condition, probably due to the lack of a manual assessment process to evaluate bones and muscular components of the thoracic outlet. In this situation, the manual treatment performed is usually generic. The present article proposes a manual evaluation that can be used to identify the anatomical area which needs to be treated. This hypothesis of assessment should be carried out after the clinician has ruled out the necessity of surgery with instrumental examinations.

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Accuracy of rib palpation for dry needling of deep periscapular musculature, measured with ultrasound

Cushman

Scholl

Ludlow

et al. 2021

Journal of Bodywork and Movement Therapies

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The relationship between various anatomical landmarks used for localizing the first rib during surface palpation

Cited by 4 publications

References 10 publications

First rib dysfunction in patients with neck and shoulder pain: a Delphi investigation

First rib dysfunction in patients with neck and shoulder pain: a Delphi investigation

New Proposal of Evaluation of the Thoracic Outlet

Accuracy of rib palpation for dry needling of deep periscapular musculature, measured with ultrasound

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