In patients with cervical rib syndrome, the work of raising the elbow is easily fatigued, and the hands are weak and unconsciously drop their holdings. Commonly found in fish and reptiles and degenerating in humans, cervical ribs is the name given to an abnormal anatomical structure in humans and is generally considered one of the most common causes of thoracic outlet syndrome. Not all people with cervical ribs are symptomatic, and when those with cervical ribs develop symptoms, it should be considered a disease, known as cervical rib syndrome. Cervical rib syndrome rarely occurs in people under the age of 30. How to diagnose hand weakness unconsciously dropping holdings? 1. Symptoms (1) It occurs in women after 40 years of age, more on the right than on the left. (2) Neck discomfort, stiffness, neck and shoulder pain, radiating to the elbow joint, ulnar side of the forearm, 4 and 5 fingers of the hand at the same time, pain with numbness, great pain during the day, and relief at rest. The pain disappears or decreases when the upper limb is raised; the pain increases when the upper limb is pulled downward. (3) Easily fatigued when lifting the elbow, hand weakness, unconscious dropping of holdings. (4) Repeated swelling, coldness, pallor, cyanosis or numbness and tingling in the hand and fingers, which are manifestations of vascular involvement. Gangrene between the fingers may occur in extremely severe cases. Sometimes sympathetic symptoms are not easily distinguished from vascular symptoms. 2. Signs (1) Basal pressure pain in the neck and limitation of cervical spine movement. (2) Pressure in the cervical rib area can lead to local pressure pain and radiating pain. (3) Occasionally, a full pulsation can be palpated in the supraclavicular region and a mass with pressure pain can be palpated. A murmur can be heard at the subclavian artery. The patient’s hand is cold and the radial artery pulsation is weak or even absent. The skin is shiny, the nails are broken or ulcers occur between the fingers. In severe cases, motor symptoms appear, with weakness of the affected hand, muscular atrophy and tremor of the intrinsic hand muscles. (4) Sensory hypersensitivity of the 4th and 5th fingers with atrophy of the interosseous and lesser interosseous muscles and the mother intrinsic muscle when the ulnar nerve is compressed. The median nerve is affected by atrophy of the greater interosseous muscle, and sometimes the biceps and triceps and radial reflexes are reduced. Cervical rib syndrome mostly occurs above 30 years of age, and its condition is somewhat similar to the onset and symptoms of cervical spondylosis, which needs to be differentiated clinically; in addition, scapular band prolapse, high sternum, high first rib, low brachial plexus and anterior oblique muscle hypertrophy can cause symptoms similar to cervical rib, because they all compress the brachial plexus nerve and subclavian artery and produce symptoms. A strict clinical differentiation is also required for diagnosis. Other diseases that need to be differentiated include cervical disc herniation, rib lock syndrome, hyperextension syndrome, myelomeningocele, spinal cord tumor, ulnar carpal tunnel syndrome, and Raynaud’s disease. This disease is a congenital disease, there is no effective preventive measures, early diagnosis and early treatment is the key to the prevention and treatment of this disease, but it should be noted that not all people with cervical ribs will have symptoms, the first choice should be conservative treatment, conservative treatment is not effective then take surgery to avoid unnecessary damage to patients.