ramu's sign to clinically elicit lower cervical spinal nerve traction/compression
DESCRIPTION
A new clinical entity in evaluating cervical neural compression. Helps assess status of anatomic variation of cervical spine and cervical spinal nerves.TRANSCRIPT
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Ramu’s SignPersons with a conical neck, especially in the antero lateral area of root
of neck, often feel a vague pain which aggravates by applying local
pressure on the said area, rarely a radiating pain down the ipsilateral
arm may also be elicited. The Brachial plexus in such situations is
subjected to kink over the elevated tissue, soft and bony, caused by
hypertrophic transverse processes of C7 vertebrae or cervical ribs. The
kink leads to a tightness and traction on the spinal nerves, increasing
with advancing age and reduced physical activity. This is demonstrable
in radiographs & MRIs of root of neck. The said pain is not felt in
persons with normal transverse processes of C7 vertebra or in absence of
cervical rib/band.
Presence of prefixed cervical spinal nerves may also give a similar sign.
The point to ponder is, if hypertrophied transverse processes of C7
spine/cervical rib/cervical band happen to coexist with prefixed spinalnerves.
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Prominent & hypertrophied Transverse Process of C7 Vertebra
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Magnified view
Prominent & hypertrophied Transverse Process of C7 Vertebra
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Yet another such situation, much grosser
Note the conical form of neck & dimpled Rt. C7 transverse process
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Yet another case
Bilateral Cervical Ribs
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X Ray & MRI of neck of a young male with Ramu’s sign. Presented with brachialgia Right side.
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EnlargedView ofthe sameMRI
Note kinkIn spinalnerves inthe firsttwo screens
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X-Ray ofmy ownNeck
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This feature is not a known or traceable entity in literature and I humbly dedicate this phenomenon to
my God Father Dr D Ramu garuas Ramu’s Sign
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Dr V S N Rajuemail : [email protected]
WADEM 2011 BIEGING, CHINA
ARC Orthopaedic Clinic, ECIL, ARC Road, Hyderabad, INDIA