![]() Controversies exist because of the lack of level 1 evidence. There are differences in classification and diagnostic approaches because of the heterogeneity of symptoms, anatomy, and treating disciplines. 7- 9 The syndrome's prevalence has been estimated at 10 per 100 000 people and may be dramatically higher in athletes. Devastating functional, emotional, and financial impairment resulting in job loss and lifelong disability are potential outcomes of this syndrome if not treated successfully.Ĭompressive structures may include cervical ribs and other bony, muscular, or fibrous anomalies of the thoracic outlet. Although TOS is a treatable disorder, patients frequently live with pain, discomfort, uncertainty, and disability. TOS often remains undiagnosed in patients complaining of diffuse numbness, chronic pain of the head and neck, and pain and weakness of the upper extremities. 1 Thomas and Cushing, Murphy, Peet, and other authors described variations of the condition which is nowadays called “thoracic outlet syndrome.” 2- 6 Willshire presented the first description of symptoms related to a supplementary cervical rib in 1860. The thoracic outlet syndrome (TOS) comprises a group of disorders caused by the compression of the neurovascular bundle at the thoracic outlet by bony, muscular, or fibrous structures. ![]() ABBREVIATIONS: AA axillary arch AT Adson test aTOS arterial thoracic outlet syndrome AWMF Arbeitsgemeinschaft der wissenschaftlichen medizinischen Fachgesellschaften BBR bilateral breast reduction surgery BTX botulinum toxine CCM costoclavicular maneuver CDC clinical diagnostic criteria CR cervical rib CTS carpal tunnel syndrome DASH disabilities of the arm EANS European Association of Neurosurgical Societies EAST elevated arm stress test FRR first rib resection FRR plus PLASTY first rib resection plus endovenous balloon venoplasty KT Kinesio taping MCS mental component scores MRA magnetic resonance angiography NHP Nottingham Health Profile nTOS neurogenic thoracic outlet syndrome PCS physical component scores PT physiotherapy QD quick DASH RCT randomized controlled trial SCP supraclavicular pressure SF-36 Short Form Health Survey SNBP supraclavicular neuroplasty of brachial plexus TFRR transaxillary first rib resection TOS thoracic outlet syndrome ULTT upper limb tension test US ultrasound vTOS venous thoracic outlet syndrome. ![]()
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