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Cervical spine and chest radiographs are useful to rule out the uncommon cervical rib, long transverse process of C7, abnormal clavicle fracture healing, cervical spondylolysis, narrowed intervertebral space, and osteophytes impinging on the neural foramina. Accessory ribs are found in approximately 0.27% of the general population and are more common in women (77%) .

Color-flow duplex may demonstrate abnormalities in venous or arterial flow, and MRI can be useful to rule out nerve or cord compression from degenerative changes in the cervical spine or herniated discs. Magnetic resonance angiography is useful in establishing the diagnosis of the rare vascular compromise subset of TOS.

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