CLINICAL-THORACIC OUTLET SYNDROME (TOS)

SUMMARY

TOS has been classified into 3 categories based on etiology, clinical presentation or anatomy; demonstrated using the Roos & Adson tests:

1. Arterial TOS (1%): digital ischemia, claudication, typically related to a cervical rib

2. Venous TOS (2-3%): due to subclavian vein obstruction from thrombosis/scarring, UL swelling is common

3. Neurogenic TOS (95%): brachial plexus is compressed; paresthesia and pain in the neck, shoulder, and arm are common; symptoms are worse with overhead motion

Reference(s)

Wilkinson, I., Furmedge, D. and Sinharay, R. (2017). Oxford handbook of clinical medicine. Oxford: Oxford University Press. Get it on Amazon.
Feather, A., Randall, D. and Waterhouse, M. (2020). Kumar And Clark’s Clinical Medicine. 10th ed. S.L.: Elsevier Health Sciences. Get it on Amazon.
Hannaman, R. A., Bullock, L., Hatchell, C. A., & Yoffe, M. (2016). Internal medicine review core curriculum, 2017-2018. CO Springs, CO: MedStudy.
Therapeutic Guidelines. Melbourne: Therapeutic Guidelines Limited. https://www.tg.org.au [Accessed 2021].