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Thoracic outlet syndrome (TOS) is a condition in which there is compression of the nerves, arteries, or veins in the superior thoracic aperture, the passageway from the lower neck to the armpit, also known as the thoracic outlet. [1] There are three main types: neurogenic, venous, and arterial. [1]
thoracic outlet syndrome Wright's test is a clinical sign in which the radial pulse weakens or disappears when the arm is abducted and externally rotated . [ 1 ] [ 2 ] It occurs in some patients with thoracic outlet syndrome .
thoracic outlet syndrome Adson's sign is the loss of the radial pulse in the arm by rotating head to the ipsilateral side with extended neck following deep inspiration. It is sometimes used as a sign of thoracic outlet syndrome (TOS). [ 1 ]
Pectoralis minor syndrome (PMS) is a condition related to thoracic outlet syndrome (TOS) that results from the pectoralis minor muscle being too tight. [1] PMS results from the brachial plexus being compressed under the pectoralis minor [2] while TOS involves compression of the bundle above the clavicle. In most patients, the nerves are ...
The brachial plexus may also be compressed by surrounding damaged structures such as bone fragments or callus from the clavicular fracture, and hematoma or pseudoaneurysm from vascular injury. Cervical rib, prominent transverse process, and congenital fibrous bands can also compress the brachial plexus and cause thoracic outlet syndrome. [14]
Various imaging techniques can also be used to show nerve compression such as x-ray for the wrist, and MRI for the thoracic outlet and cervico-brachial areas. Utilization of routine imaging is useful in early detection and treatment of overuse injuries in at risk populations, which is important in preventing long term adverse effects.
A positive Pemberton's sign is indicative of superior vena cava syndrome (SVC), commonly the result of a mass in the mediastinum.Although the sign is most commonly described in patients with substernal goiters where the goiter "corks off" the thoracic inlet, [4] the maneuver is potentially useful in any patient with adenopathy, tumor, or fibrosis involving the mediastinum.
Magnetic resonance angiography (MRA) is a group of techniques based on magnetic resonance imaging (MRI) to image blood vessels. Magnetic resonance angiography is used to generate images of arteries (and less commonly veins) in order to evaluate them for stenosis (abnormal narrowing), occlusions, aneurysms (vessel wall dilatations, at risk of rupture) or other abnormalities.