Discover

'Thoracic outlet syndrome' (TOS) consists of a group of distinct disorders that affect the nerves in the brachial plexus (nerves that pass into the arms from the neck) and various nerves and blood vessels between the base of the neck and axilla (armpit).

Contents

Presentation

Causes

Classification

Treatment

Notable patients

References

External links

Presentation

The disorders are complex, somewhat confusing, and poorly defined, each with various signs and symptoms not only arising from the upper extremity but also from the chest, neck and head. The chest pain can mimic angina pain. It is unknown whether this condition is fatal.
Neurological symptoms are by far the commonest presentation (95% of cases).
When presenting with venous compression (1–2% of cases) it is known as Paget – Schroetter syndrome.
Adson's test is commonly performed in clinical practice to test for this syndrome.

Causes

For the most part, these disorders are produced by positional compression of the subclavian artery and vein, the vertebral artery, and the nerve cords of the brachial plexus.
TOS may also result from a cervical band, abnormalities of the scalene muscles (including hypertrophy) and trauma.

Classification

The following taxonomy of TOS is used in ICD-9-CM and other sources:

★ Scalenus anticus syndrome (compression on brachial plexus and/or subclavian artery caused by muscle growth) - diagnosed by using Adson's sign with patient's head turned outward

★ Cervical rib syndrome (compression on brachial plexus and/or subclavian artery caused by bone growth) - diagnosed by using Adson's sign with patient's head turned inward

★ Costoclavicular syndrome (narrowing between the clavicle and the first rib) -- diagnosed with costoclavicular maneuver^[1]

Treatment

Only a few patients will require surgical decompression. In most, advice on posture and physiotherapy will suffice.

Notable patients

Major League Baseball player Hank Blalock has recently been diagnosed with Thoracic outlet syndrome.

References

1.

External links

★

★ American Thoracic Outlet Syndrome Association [1]

★ Tos-Syndrome.com

★ Journal of American Chiropractic Association

★ Adson's test [2]