Chapter 14: Diagnosis and Management of Thoracic Outlet Syndrome
The following sections are included:
Thoracic outlet syndrome (TOS) is caused by compression on neurovascular bundle in the thoracic outlet tunnel.
TOS can be neurogenic (90%), venous (5%), arterial (1%), or any combination of the above three.
Physical examination is more reliable in the venous and arterial forms but is not straightforward in the neurologic form where more objective tests are required.
Provocative tests have high false positive rates.
Dynamic imaging has more diagnostic value than standard imaging.
Neurologic TOS should be referred to physiotherapy for postural correction and muscle exercise.
Venous and arterial TOS are treated with surgical decompression and blood vessel reconstructive procedures. The rule is ‘the sooner, the better’.
