Atrophy of intrinsic muscles of hand, sensory deficit on medial side of forearm and hand, and diminished radial pulse on turning the head on the affected side could be because of :

- Cervical ribs (present in upto 1% of people) articulatewith the C7 vertebra and are clinically significant because they may compress spinal nerves C8 and T1 or the inferior trunk of the brachial plexus supplying the upper limb. Tingling and numbness may occur along the medial border of the forearm. They may also compress the subclavian artery, resulting in ischemic muscle pain (caused by poor blood supply) in the upper limb.