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Thoracic Outlet Syndrome

Robert A. Baldor, MD, FAAFP Reviewed 06/2019
 


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

  • Neurologic type, upper plexus (C4–C7)

    • Pain and paresthesias in head, neck, mandible, face, temporal area, upper back/chest, outer arm, and hand in a radial nerve distribution

    • Occipital ...

TREATMENT

GENERAL MEASURES

  • Conservative management usually involves approaches to reduce and redistribute pressure and traction through the use of physiotherapy or prosthesis.

  • Physical therapy is first-...

ONGOING CARE

FOLLOW-UP RECOMMENDATIONS

Correct improper posture, practice proper posture, exercises to strengthen shoulder elevator and neck extensor muscles, stretching exercises for scalene muscles, ...

REFERENCES

1
Magill ST, Brus-Ramer M, Weinstein PR, et al. Neurogenic thoracic outlet syndrome: current diagnostic criteria and advances in MRI diagnostics. Neurosurg Focus.  2015;39(3):E7. [View ...

ADDITIONAL READING

Povlsen B, Belzberg A, Hansson T, et al. Treatment for thoracic outlet syndrome. Cochrane Database Syst Rev.  2010;(1):CD007218. [View Abstract on OvidMedline] 

CODES

ICD10

G54.0 Brachial plexus disorders 

ICD9

353.0 Brachial plexus lesions 

SNOMED

  • 128210009 thoracic outlet syndrome (disorder)

  • 211236007 Scalenus anticus syndrome (disorder)

  • 413577001 Arterial thoraci...

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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