Duplex ultrasound in the evaluation of venous and arterial thoracic outlet syndrome

Hu, Jian; Biederman, Robert W; Kashyap, Kartikeya; Wilson, John T.; Farah, Victor; Franco, Todd; Nguyen, Vina P.

doi:10.1177/2054270420983101

Cited by 5 publications

(3 citation statements)

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“…The sensitivities of these tests are different in TOS detection as, for example, Adson’s test has an estimated 85% sensitivity [ 11 , 12 , 13 ]. There is a general agreement that supports the effectiveness of Duplex and Doppler ultrasonography, and a low percentage of false positive TOS diagnoses has been documented [ 5 , 13 , 14 ].…”

Section: Introductionmentioning

confidence: 93%

“…These symptoms are reproducibly aggravated by any activity that requires arm elevation [ 4 ]. Neurogenic TOS is the most common type of TOS, and according to the description by Hu et al, it covers 90% of TOS cases [ 5 ]. Venous TOS is the second most common type of TOS, representing approximately 3% of cases, which manifests itself in lividity and pain, muscle weakness in the upper extremities, and arm swelling, subsequently increasing over a long period of time [ 6 , 7 ].…”

Section: Introductionmentioning

confidence: 99%

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Relationships between the Clinical Test Results and Neurophysiological Findings in Patients with Thoracic Outlet Syndrome

et al. 2022

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A thoracic outlet syndrome (TOS) is the type of brachial plexus disorder most difficult to objectively assess using a clinical examination and differential diagnosis. Its symptoms can be frequently misdiagnosed, especially among others with cervical disc-root conflicts, plexopathies, and peripheral neuropathies. In this study, we aim to identify the correlations between positive Doppler ultrasonography results indicating pathological changes in the subclavian flow velocity, clinical tests, and chosen clinical neurophysiology recordings as proposed alternative or supplementary diagnostic tools for evaluating TOS patients. Sixty TOS patients with positive Doppler ultrasonography and Roos test results and sixty healthy people as a control group were bilaterally examined, and the results were compared. Pain intensity was assessed using a visual analogue scale (VAS). Sensory perceptions within C4–C8 dermatomes were assessed with Von Frey filament (FvF) tests. The activity of motor units in the proximal and distal muscles of the upper extremities was evaluated using surface electromyography (sEMG) during maximal contractions before and after a provocative raised hands test (RHT). An electroneurography (ENG) was used to evaluate the transmission of nerve impulses peripherally. Motor evoked potential (MEP) recordings, induced by the over-vertebral magnetic stimulation of the C5–C7 neuromeres, were used to examine motor transmissions from the cervical motor centres to the upper extremities muscles. The results revealed a relationship between positive Doppler test scores and pathological changes in the subclavian flow velocity through the results of the following diagnostic tools: a VAS score of 1.9 was detected on average, superficial sensory perception abnormalities were found in the innervation areas of the ulnar nerves detected by FvF tests, a decrease in the amplitudes of sEMG recordings was seen in distal rather than proximal muscles (especially following the RHT), a decrease in the motor and sensory peripheral transmissions of nerve impulses in the median, ulnar and cutaneous anterobrachial median nerves was seen, as well as MEP amplitudes recorded from the abductor pollicis brevis muscle. The provocative RHT combined with sEMG and MEP recordings can be considered accurate and objective clinical neurophysiology tools that could supplement the commonly used clinical tests. Such an approach may result in a more precise neurogenic TOS diagnostic algorithm.

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Section: Introductionmentioning

confidence: 93%

Section: Introductionmentioning

confidence: 99%

Relationships between the Clinical Test Results and Neurophysiological Findings in Patients with Thoracic Outlet Syndrome

et al. 2022

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“…Thoracic outlet syndrome (TOS) is characterized by neurological and vascular symptoms. The condition is caused by the compression of the subclavian vessels and brachial plexus (BP) as they exit the thoracic chest [1][2][3]. TOS is classified into three distinct forms, according to its pathophysiology: the neurogenic thoracic outlet syndrome (NTOS) after the BP compression, the arterial thoracic outlet syndrome (ATOS) after the subclavian artery (SCA) compression, and the venous thoracic outlet syndrome (VTOS) after the subclavian vein (SCV) compression [4].…”

Section: Introductionmentioning

confidence: 99%

Anatomy and Pathogenesis of Vascular Thoracic Outlet Syndrome

Perdikakis¹,

Sinou²,

Angelis³

et al. 2023

Cureus

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The current literature review article describes the anatomy and pathogenesis of the vascular nature of thoracic outlet syndrome (TOS), as well as gathers the latest and most important information concerning its diagnostic methods and treatment. This syndrome's subcategory includes the venous and the arterial. Data for this review was accumulated through the PubMed database in which only scientific studies published in the last decade (2012-2022) were searched. PubMed offered 347 results, of which 23 were judged suitable and used.Non-invasive methods both for the diagnosis and the treatment of vascular TOS are gaining ground. Medicine, at this point, finds itself on the verge of slowly putting aside the previous invasive gold-standard methods, to be used only in the most urgent situations. The vascular thoracic outlet condition is a rare form of TOS but is also the most trouble-causing one and the deadliest. Fortunately, it can be more efficiently managed because of the current medical innovations. However, further research is needed to establish their already confirmed effectiveness, so they can be even more widely trusted and used.

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Point-of-Care Ultrasound in the Diagnosis of Venous Thoracic Outlet Syndrome

Meyer

Guttman

2022

The Journal of Emergency Medicine

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Duplex ultrasound in the evaluation of venous and arterial thoracic outlet syndrome

Abstract: Lesson We are reporting a case of thoracic outlet syndrome and the value of duplex in the diagnosis of this syndrome.

Cited by 5 publications

References 10 publications

Relationships between the Clinical Test Results and Neurophysiological Findings in Patients with Thoracic Outlet Syndrome

Relationships between the Clinical Test Results and Neurophysiological Findings in Patients with Thoracic Outlet Syndrome

Anatomy and Pathogenesis of Vascular Thoracic Outlet Syndrome

Point-of-Care Ultrasound in the Diagnosis of Venous Thoracic Outlet Syndrome

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