Thoracic outlet syndrome
Template:DiseaseDisorder infobox
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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).
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]
Diagnosis
Adson's sign and the costoclavicular maneuver are notoriously inaccurate, and may be a small part of a comprehensive history and physical examination of a patient with TOS. There is currently no single clinical sign that makes the diagnosis of TOS with certainty. Arteriography, while only rarely used to evaluate thoracic outlet syndrome, may be used if a surgery is being planned to correct an arterial TOS.[2]
Treatment
Only a few patients will require surgical decompression. In most, advice on posture and physiotherapy or osteopathy will suffice.
References
- ↑ Template:FPnotebook
- ↑ Thoracic outlet syndrome Mount Sinai Hospital, New York
External links
- Template:NINDS
- American Thoracic Outlet Syndrome Association [3]
- Tos-Syndrome.com
- Journal of American Chiropractic Association
- Adson's test [4]
Template:SIB Template:PNS diseases of the nervous system
nl:Thoracic outlet syndrome fi:Hartiapunoksen vammautuminen tai ahtautuminen