Thoracic Outlet Syndrome: Diagnostic Accuracy of MRI
ConclusionMRI can contribute to the diagnosis of TOS. Specificity is sufficiently high to provide guidance for planning the surgical procedure. Sensitivity, however, is too low for MRI to be useful as a screening test. MRI should be used in combination with the clinical assessment and other investigations to assist in the diagnosis of TOS.Level of evidenceIV, retrospective cohort study.
Introduction: The typical presentation of arterial thoracic outlet syndrome (TOS) is an acute onset of upper-extremity ischemia secondary to thromboembolism. However, patients with chronic positional arterial compression at the thoracic outlet (TO) may be asymptomatic or may have symptoms of neurologic compromise including numbness, coldness, weakness and pain. Here we present a patient with unrecognized arterial compression by cervical rib at the TO.
Introduction: Neurogenic Thoracic Outlet Syndrome (NTOS) is a clinical entity where compression of the brachial plexus is accountable for development of upper-extremity symptoms. The NTOS diagnosis is generally based on clinical judgment because adequate diagnostic imaging techniques are missing. However, recently, high-resolution ultrasound (HRUS) of the brachial plexus was suggested as a potential valuable diagnostic imaging technique for NTOS. The aim of this prospective study was to determine the diagnostic value of HRUS in NTOS patients.
Publication date: Available online 29 November 2019Source: Microvascular ResearchAuthor(s): Jeanne Hersant, Pierre Ramondou, Celine Guilleron, Jean Picquet, Samir Henni, Pierre AbrahamAbstractObjectiveTo determine if using a telephone can induce forearm pain and ischemia.DesignProspective case-control trial.SettingVascular laboratory in the university hospital in Angers between September 2018 and March 2019.ParticipantsFifteen apparently healthy subjects (controls) and 32 patients with suspected thoracic outlet syndrome (TOS) of vascular or non-vascular origin.InterventionHand-holding a cellular phone to answer a call from...
Thoracic outlet syndrome occurs when something compresses the nerves, arteries, or veins that pass through the thoracic outlet. Learn more about this condition, including symptoms and treatment options, here.
ConclusionsDuplex ultrasound has significant limitations in the initial evaluation of patients with suspected SCV thrombosis, with false-negative results in 21% of patients with proven VTOS. This is rarely acknowledged in ultrasound reports, but false-negative ultrasound studies have the potential to delay definitive imaging, thrombolysis, and further treatment for VTOS. Initial false-negative ultrasound results are associated with progressive thrombus extension and a more frequent need for SCV bypass reconstruction at the time of surgical treatment.Graphical Abstract
Rationale: Venous thoracic outlet syndrome (VTOS) secondary to subclavian arterial stent implantation is extremely rare. Here, we firstly report this disease and the endovascular intervention using covered-stents. Patient concerns: An 80-year-old man who had received an acceptable stent implantation for the treatment of a right subclavian arteriovenous malformation (AVM), presented with a gradually increasing swelling and pain in his right upper extremity. Diagnosis: The patient was diagnosed with right VTOS and recurrent subclavian AVM following ultrasonography and computed tomographic angiography. Interventions:...
Condition: Thoracic Outlet Syndrome Intervention: Other: non interventionnal study Sponsor: Nantes University Hospital Not yet recruiting
This article reviews the anatomy of the brachial plexus and describes the technique for magnetic resonance neurography and the most common pathologic conditions that can affect the brachial plexus. PMID: 26860655 [PubMed - as supplied by publisher]