Thoracic outlet syndrome – Thoracic outlet syndrome (TOS) refers to a constellation of signs and symptoms arising from compression of the upper extremity neurovascular bundle by various structures in the area just above the first rib and behind the clavicle, typically within the confined space of the thoracic outlet. The term thoracic outlet syndrome is not a specific diagnosis, and the appropriate type of TOS, such as neurogenic (nTOS), arterial (aTOS), or venous (vTOS) thoracic outlet syndrome, should be used.
Causes –Thoracic outlet syndromes are due to rib anomalies, muscular anomalies, or a result of injury. Cervical ribs predispose the patient to TOS after hyperextension-flexion (whiplash) injury. The absence of a rib anomaly makes the diagnosis of arterial thoracic outlet syndrome less likely. Many patients with nTOS have a prior history of neck trauma or repetitive occupational and physical stress. Similarly, vTOS is highly associated with repetitive movements, particularly with repetitive overhead upper extremity movements.
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