![]() ![]() If the subclavian vein is compressed, there may be swelling of the arm, distension of the veins or a diffuse pain in the arm or hand. Vascular thoracic outlet syndrome is seen less frequently than the neurogenic type.Stellate ganglion involvement may be possible. If there is compression of autonomic nerves, cold hands, swelling or blanching can occur.There may also be a painful neck and headache. Symptoms are often vague and general and may affect the whole arm. Numbness or tingling of the upper limb may be reported. In the neurogenic type, there may be painless wasting of the muscles of the hand, resulting in weakness (eg, difficulty in grasping a racket). Symptoms will depend on the type of thoracic outlet syndrome.The true form is accompanied by objective findings whereas the disputed form (which is in fact far more common) is not. Neurogenic thoracic outlet syndrome can be subcategorised into true or disputed. The vascular type can be further categorised into arterial or venous. Two main types of thoracic outlet syndrome have been identified - vascular (arterial and/or venous) and neurogenic. Benign tumours may also cause thoracic outlet syndrome.ĭiagnosis of thoracic outlet syndrome may be difficult and depends upon a thorough history and examination together with supportive tests. Pancoast tumours can invade and compress the brachial plexus. Malignancy may also cause thoracic outlet syndrome. Various anatomical variations may cause thoracic outlet syndrome - eg, cervical rib or congenital muscle variations.Overuse injury in the setting of repetitive movements can cause swelling, small haemorrhages, and subsequent fibrosis, which can also lead to symptoms. ![]() Repetitive motion can lead to muscle hypertrophy that contributes to compression.Subsequent fibrosis may also produce symptoms. Haemorrhage, haematoma or displaced fracture (eg, midshaft clavicular fracture) can directly compress the nerves and/or blood vessels. Trauma is typically high velocity, most often in the setting of a motor vehicle accident.There are many possible causes, including trauma, repetitive motions and anatomical variations: T horacic outlet syndrome (TOS) is a collection of symptoms in the shoulder and upper extremity area that results in pain, numbness, and tingling. ![]()
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