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Adson-Coffey syndrome

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Thoracic outlet syndrome with compression of the nerves and vessels in the outlet of the thorax and the costoclavicular area or between the clavicle and the first rib. The symptoms are identical with those of cervical rib syndrome and vary in all degrees from mild to severe. Symptoms include pain involving the chest wall, shoulder, arm and hand, unilateral sensory disturbance of the upper limb, with numbness and tingling along ulnar border of the forearm, skin colour changes, claudication, diminished pulse, lowered blood pressure on the affected side, and wasting and weakness of the muscles of the hand and forearm.

The most common cause of compression of the brachial plexus and subclavian artery is the scalenus anticus muscle. Alfred Washington Adson in 1927 and Howard Christian Naffziger in 1935 demonstrated that complete relief of symptoms could be obtained by severing the scalenus anticus muscle, regardless the presensce or absence of a cervical rib. Alton J. Cosier (born 1896), Gage, and Michael Ellis DeBakey (born 1908) first introduced the term "scalenus anticus syndrome" in 1935.

See also Haven's syndrome, or scalenus neurocirculatory compression syndrome, under Hale Haven, American neurologist, born 1902.


  • F.-J. Hunauld.
    Communications to the Royal Academy of Sciences in 1740. Amsterdam, 1744.
  • Richard Holmes Coote:
    Pressure of the axillary vessels and nerve by exostosis from a cervical rib. Interference with the circulation of the arm. Removal of the rib and exostosis. Recovery.
    Medical Times and Gazette, London, 1861, 2: 108.
  • Wenzel Leopold Gruber (1814-1890):
    Über die Halsrippen des Menschen mit vergleichenden anatomischen Bemerkungen. Mémoires de l’Académie impériale des sciences de St.-Pétersbourg, 1869, 13.
  • A. W. Adson, J. R. Coffey:
    Cervical rib. A new method of anterior approach for relief of symptoms by division of the scalenius anticus.
    Annals of Surgery, Philadelphia, 1927, 85: 839-857.
  • H. C. Naffziger:
    The scalenus syndrome.
    Surgery, Gynecology and Obstetrics, Chicago, 1937, 64: 119-120.

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