Thoracic Outlet Syndrome: A Primer on Objective Methods of Diagnosis

Braun, Richard M.

doi:10.1016/j.jhsa.2010.03.018

Cited by 16 publications

(13 citation statements)

References 12 publications

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“…Maneuvers such as the Wright test (hyperabduction leading to increased pain or AbbreviAtioNs ACDF = anterior cervical discectomy and fusion; DTI = diffusion tensor imaging; MRC = Medical Research Council; MRN = magnetic resonance neurography; NCS = nerve conduction study; NEE = needle electrode examination; nTOS = neurogenic thoracic outlet syndrome; SPAIR = spectral adiabatic inversion recovery; STIR = short-tau inversion recovery. 3 Supraclavicular tenderness or a Tinel sign may also be present. The location of the compression can be determined based on physical findings as well.…”

Section: Neurosurg Focus 39 (3):e7 2015mentioning

confidence: 99%

Neurogenic thoracic outlet syndrome: current diagnostic criteria and advances in MRI diagnostics

Magill¹,

Brus-Ramer

Weinstein³

et al. 2015

FOC

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Neurogenic thoracic outlet syndrome (nTOS) is caused by compression of the brachial plexus as it traverses from the thoracic outlet to the axilla. Diagnosing nTOS can be difficult because of overlap with other complex pain and entrapment syndromes. An nTOS diagnosis is made based on patient history, physical exam, electrodiagnostic studies, and, more recently, interpretation of MR neurograms with tractography. Advances in high-resolution MRI and tractography can confirm an nTOS diagnosis and identify the location of nerve compression, allowing tailored surgical decompression. In this report, the authors review the current diagnostic criteria, present an update on advances in MRI, and provide case examples demonstrating how MR neurography (MRN) can aid in diagnosing nTOS. The authors conclude that improved high-resolution MRN and tractography are valuable tools for identifying the source of nerve compression in patients with nTOS and can augment current diagnostic modalities for this syndrome.

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Section: Neurosurg Focus 39 (3):e7 2015mentioning

confidence: 99%

Neurogenic thoracic outlet syndrome: current diagnostic criteria and advances in MRI diagnostics

Magill¹,

Brus-Ramer

Weinstein³

et al. 2015

FOC

View full text Add to dashboard Cite

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“…Electroneurographical changes in NTOS may be absent. Therefore, NTOS diagnose depends on clinical examination [ 9 ] and imaging [ 5 ]. Muscle strength should always be tested in the position in which the patient feels weaknesses or constraints, as SPM is not constantly active [ 2 ].…”

Section: Case Presentationmentioning

confidence: 99%

Neurogenic thoracic outlet syndrome due to subclavius posticus muscle with dynamic brachial plexus compression: a case report

et al. 2015

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BackgroundNeurogenic thoracic outlet syndrome is an underestimated cause of brachial weakness and pain. The subclavius posticus muscle (SPM) is an aberrant muscle originating from the medial aspect of the first rib reaching to superior border of the scapula, which may cause, depending on its activation, dynamic compression of the brachial plexus.Case presentationIn the present study, we report about a 32-year-old male caucasian patient with weakness in radial deviation of his left hand. An isolated macrodactyly of his left middle finger had been operated twice. Electroneurography showed a carpal-tunnel-syndrome (CTS) on the left side. MRI of the brachial plexus revealed an additional muscle in the costoclavicular space, identified as SPM. To our knowledge, this is the second case report of a neurogenic thoracic outlet syndrome due to SPM, and the first case described with isolated macrodactyly and CTS in the same patient.ConclusionIf complaints about hand weakness are only reported in cases of distinct hand positions, a dynamic compression of the brachial plexus by SPM may be the cause. A neurogenic thoracic outlet syndrome may facilitate the development of CTS.

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“…These symptoms are predominantly associated with a history of vigorous physical activity but can also be associated with an underlying hypercoagulable disorder. 1,2 Adolescent patients with neurogenic TOS can present with pain and numbness caused by compression of the brachial plexus by the anterior scalene muscle, the first rib, or anomalous fibrous bands. 1 The anatomical compression is often a result of trauma or repetitive motion injuries.…”

mentioning

confidence: 99%

“…1,2 Adolescent patients with neurogenic TOS can present with pain and numbness caused by compression of the brachial plexus by the anterior scalene muscle, the first rib, or anomalous fibrous bands. 1 The anatomical compression is often a result of trauma or repetitive motion injuries. 1 Arterial TOS is rare, and patients often present with acute or chronic ischemia of the arm.…”

mentioning

confidence: 99%