Thoracic outlet syndrome

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Summary of Thoracic outlet syndrome

Thoracic outlet syndrome involves compression at the thoracic inlet, which is known clinically as the superior thoracic outlet, resulting from excess pressure placed on the neurovascular bundle passing between the anterior scalene and middle scalene muscles. It can affect one or more of the nerves that innervate the upper limb and/or blood vessels as they pass between the chest and upper extremity, specifically in the brachial plexus, the subclavian artery, and rarely, the subclavian vein.

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Thoracic outlet syndrome

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An 18-year-old female comes to the clinic complaining of weakness and loss of sensation in her left arm and hand as if she had "hit her funny bone." She reports that this weakness and loss of sensation started after she had a car accident a couple of weeks ago during which she dislocated her shoulder. Her shoulder "popped right back in" so she did not receive medical attention at the time. Physical examination shows mild edema in her arm and that her strength is only a 4/5 on the left while it is 5/5 on the right. Which test(s) could be used to confirm your diagnosis?

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