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Thoracic Outlet Syndrome

Ashley Nicole Koontz, DO and Jayson R Loeffert, DO Reviewed 06/2022
 


BASICS

DESCRIPTION

  • This syndrome consists of a constellation of symptoms that affect the head, neck, shoulders, and upper extremities caused by compression of the neurovascular structures (brachial ple...

DIAGNOSIS

HISTORY

  • nTOS

    • High index of suspicion for history of MVA trauma and overhead lifting athletes

    • 76% of patients will have occipital headache (2)

    • Symptoms of the upper plexus (C5–C7)

      • ...

TREATMENT

GENERAL MEASURES

  • Conservative management usually involves approaches to reduce and redistribute pressure and traction on the thoracic outlet

  • Physical therapy is first-line treatment along with...

ONGOING CARE

FOLLOW-UP RECOMMENDATIONS

Practice proper posture, exercises to strengthen shoulder elevator and neck extensor muscles, stretching exercises for scalene muscles, support bra for women with...

REFERENCES

1
Li N, Dierks G, Vervaeke HE, et al. Thoracic Outlet Syndrome: A Narrative Review. J Clin Med. 2021;10(5):962. 
2
Sanders  RJ, Hammond  SL, Rao  NM. Diagnosis of thora...

CODES

ICD10

G54.0 Brachial plexus disorders 

SNOMED

  • 128210009 thoracic outlet syndrome (disorder)

  • 211236007 Scalenus anticus syndrome (disorder)

  • 413577001 Arterial thoracic outlet syndrome due to cervical ...

CLINICAL PEARLS

  • This syndrome is caused by compression of the neurovascular structures (brachial plexus and subclavian vessels) at the thoracic outlet, specifically in the area superior to the 1st rib...

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