sustained a whiplash injury in a car accident within the year, schedules an office visit for evaluation of pain she has been experiencing for 7 months in the right side of her neck and the trapezius. The pain radiates down the medial aspect of her right arm to the 4th and 5th digits, and it worsens when she brushes her hair or lifts bags of groceries. She feels her quality of life is significan...

Thoracic Outlet Syndrome (TOS) is the constellation of symptoms caused by compression of neurovascular structures at the superior aperture of the thorax, properly the thoracic inlet! The diagnosis and treatment is contentious and some even question its existence. Symptoms are often confused with distal compression neuropathies or cervical

A case of thoracic outlet syndrome (TOS) treated at the University Hospital of the West Indies, Jamaica, is presented. The diagnosis, investigation and management of TOS are discussed.

Diagnosis and treatment of thoracic outlet syndrome (TOS) involves neurologists, physiatrists, family physicians, orthopedic surgeons, vascular surgeons, thoracic surgeons, neurosurgeons and sometimes psychiatrists. It is generally accepted that TOS is caused by compression of brachial plexus elements or subclavian vessels in their passage from the cervical area toward the axilla and proximal a...

A 44-year-old woman presents with a chief complaint of neck pain with radiation of paresthesias into her left medial forearm, and fourth and fifth digits. She was involved in a rear end motor vehicle collision 2 years prior. Her symptoms are exacerbated by work (eg, typing, mousing), and combing her hair, and have remained relatively constant at 3 of 10 average, and 8 of 10 at its worst by visu...

A 32-year-old man, without previous medical history, presented with a 2 month history of severe RP involving his right hand, which was exacerbated when he practised his profession of house painter. On examination, his right hand was normal; the right wrist pulse decreased with Wright’s hyperabduction test. General physical examination was otherwise normal. Autoantibody screening tests (RF, ANA)...

Two distinct terms are used to describe vascular thoracic outlet syndrome (TOS) depending on which structure is predominantly affected: venous TOS (due to subclavian vein compression) and arterial TOS (due to subclavian artery compression). Although the venous and arterial subtypes of TOS affect only 3% and <1% of all TOS patients respectively, the diagnostic and management approaches to venous...

The diagnosis of thoracic outlet syndrome was once debated in the world of vascular surgery. Today, it is more understood and surprisingly less infrequent than once thought. Thoracic outlet syndrome (TOS) is composed of three types: neurogenic, venous, and arterial. Each type is in distinction to the others when considering patient presentation and diagnosis. Remarkable advances have been made ...

Thoracic outlet syndrome (TOS) is a symptom complex attributed to compression of the nerves and vessels as they exit the thoracic outlet. Classified into several sub-types, conservative management is generally recommended as the first stage treatment in favor of surgical intervention. In cases where postural deviations contribute substantially to compression of the thoracic outlet, the rehabili...