A 35-year-old businessman complains of tingling and numbness…

Questions

A 35-yeаr-оld businessmаn cоmplаins оf tingling and numbness in his fingers of both hands, mostly in the ring and small fingers, made worse with overhead activity. Neurologic exam and electromyography-nerve conduction study is normal. His cervical spine x-ray reveals cervical ribs arising from the seventh cervical vertebra (see image).   Which of the following conditions is the most likely diagnosis for this patient?