LAUSR

Ultrasonography is a safe and excellent method of imaging peripheral nerves and has revolutionised regional anaesthesia practice.[1] Ultrasound-guided supraclavicular brachial plexus block [US-SCBPB] has become a very popular technique due to its rapid, reproducible, and predictable characteristics, which can be attributed to the compact arrangement of the plexus in the area.[2] However, apart from vascular structures, bone-like structures such as calcified cervical lymph nodes have also been detected on scanning the supraclavicular area.[3] The presence of a cervical rib, reported in literature, either remained a bony obstruction to the needle path, without a distortion of the brachial plexus elements[3] or separated[4] and stretched[5] the brachial plexus, which may warrant a change in approach to brachial plexus blocks. Here, we describe three cases of cervical rib incidentally detected under ultrasound and confirmed by neck X-rays in the post-operative period.