University:
Western Sydney University
Course:
MEDI 2003 | Clinical Sciences 2
Academic year:

2024
Views:

411

Pages:

1
Author:

Mariam A.

Thoracic Outlet Syndrome (TOS) Anatomy and Pathophysiology:   TOS involves compression of the brachial plexus and/or subclavian vessels as they pass through the thoracic outlet, a narrow space between the clavicle and first rib. Compression can occur due to anatomical variations, trauma, or repetitive overhead activities. Clinical Features: 1. Neurogenic TOS: o Paresthesia: Numbness, tingling, and pain in the arm, shoulder, and fingers (often fourth and fifth digits). o Weakness: Muscle weakness in the affected arm, especially with overhead activities. o Symptoms Aggravated by Position: Symptoms worsen with arm abduction, elevation, or prolonged posture (e.g., sitting at a desk). o Positive Provocative Maneuvers: Adson's test, Wright's test, Roos test may reproduce symptoms. 2. Vascular TOS (Less Common): o Pallor, Cyanosis: Symptoms related to arterial compression (e.g., coldness, discoloration). o Edema: Swelling of the affected arm. o Pulse Changes: Diminished or absent radial pulse with arm maneuvers. Diagnostic Evaluation:   Clinical Assessment: Detailed history focusing on symptoms exacerbation, physical examination including provocative maneuvers. Imaging: MRI, CT angiography, or ultrasound to evaluate anatomical abnormalities or rule out other conditions. Management:   Conservative: Physical therapy, postural training, ergonomic adjustments, NSAIDs. Surgical: For severe cases or when conservative measures fail, decompression of the thoracic outlet may be considered.