Thoracic outlet syndrome

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Thoracic outlet syndrome

Nervous system

Central nervous system disorders

Spina bifida

Chiari malformation

Dandy-Walker malformation

Syringomyelia

Tethered spinal cord syndrome

Aqueductal stenosis

Septo-optic dysplasia

Cerebral palsy

Spinocerebellar ataxia (NORD)

Transient ischemic attack

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Epidural hematoma

Subdural hematoma

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Saccular aneurysm

Arteriovenous malformation

Broca aphasia

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Wernicke-Korsakoff syndrome

Kluver-Bucy syndrome

Concussion and traumatic brain injury

Shaken baby syndrome

Epilepsy

Febrile seizure

Early infantile epileptic encephalopathy (NORD)

Tension headache

Cluster headache

Migraine

Idiopathic intracranial hypertension

Trigeminal neuralgia

Cavernous sinus thrombosis

Alzheimer disease

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Normal pressure hydrocephalus

Torticollis

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Restless legs syndrome

Parkinson disease

Huntington disease

Opsoclonus myoclonus syndrome (NORD)

Multiple sclerosis

Central pontine myelinolysis

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Cauda equina syndrome

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Central and peripheral nervous system disorders

Sturge-Weber syndrome

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von Hippel-Lindau disease

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Peripheral nervous system disorders

Spinal muscular atrophy

Poliovirus

Guillain-Barre syndrome

Charcot-Marie-Tooth disease

Trigeminal neuralgia

Bell palsy

Winged scapula

Thoracic outlet syndrome

Carpal tunnel syndrome

Ulnar claw

Erb-Duchenne palsy

Klumpke paralysis

Sciatica

Myasthenia gravis

Lambert-Eaton myasthenic syndrome

Autonomic nervous system disorders

Orthostatic hypotension

Horner syndrome

Nervous system pathology review

Congenital neurological disorders: Pathology review

Headaches: Pathology review

Seizures: Pathology review

Cerebral vascular disease: Pathology review

Traumatic brain injury: Pathology review

Spinal cord disorders: Pathology review

Dementia: Pathology review

Central nervous system infections: Pathology review

Movement disorders: Pathology review

Neuromuscular junction disorders: Pathology review

Demyelinating disorders: Pathology review

Adult brain tumors: Pathology review

Pediatric brain tumors: Pathology review

Neurocutaneous disorders: Pathology review

Assessments

Thoracic outlet syndrome

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Thoracic outlet syndrome

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USMLE® Step 1 style questions USMLE

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A 23-year-old man comes to his primary care physician to evaluate the sudden onset of numbness and tingling in the right upper extremity following a workout. The patient was performing sit-ups when he experienced a sharp pain in his neck, followed by numbness and tingling in his right hand. He does not have any symptoms while at rest. He reports several similar episodes in the past. He is a bodybuilder. Vital signs are within normal limits. The right lateral neck appears larger when compared to the left lateral neck. The patient has no spinal tenderness to palpation. Which of the following is the most likely underlying cause of this patient’s symptoms?  

External References

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Pancoast tumor p. 710

thoracic outlet syndrome p. 456

Summary

Thoracic outlet syndrome (TOS) 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.

TOS 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. TOS can be caused by a variety of factors, including repetitive arm and shoulder movements, trauma, or anatomical abnormalities.

Symptoms of TOS may include pain, weakness, numbness, and tingling in the arms and hands, especially when performing overhead activities or carrying heavy objects. Treatment for TOS depends on the underlying cause and severity of the condition, and may include medications like corticosteroids, or even surgery.

Elsevier

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