ANP 36y/f came from US for second opinion regarding right ring finger nubmenss and neck pain since 5 years. She met with a car accident 14 years back, neck pain started since then. After 12 miles walk she developed syncope and right eye redness and since then gets numbness over the right chin when she is stressed.
Examination showed paracervical tenderness, most significant was Adson's test positive on right side never detected before. Carotids were normal.
Her MR cervical spine showed few disc prolapse most significant was at C5-6 which cannot explain her ring finger numbness.
Symptom increases during anxiety, and she was also labeled fibromyalgia.
Asked for vascular surgical advice and doppler of carotid and brachial vessels with neck x ray.
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