Acute upper limb ischemia due to cervical rib-related thoracic outlet syndrome.

Thoracic outlet syndrome (TOS) results from the compression of neurovascular structures at the thoracic outlet. The clinical presentation of arterial compression ranges from chronic ischemic symptoms, such as upper limb pallor, coldness, and exercise-induced claudication, to acute vascular complications including arterial thrombosis, which may progress to limb-threatening ischemia. We report the case of a 33-year-old patient with no significant medical history who presented with acute ischemia of the left upper limb. Radiological investigations revealed TOS with a cervical rib as the underlying cause of acute limb ischemia. This case underscores the pivotal role of imaging in establishing the etiological diagnosis and identifying vascular complications, thereby enabling rapid therapeutic management.