Clinical Picture of Thoracic Outlet Syndrome

neurological problems

  1. pains in the shoulder, chest, arms and hands (painful palpation in the supraclavicular area)

  2. parestesis (most often in dermatoma C8 and Th1)

  3. a muscular weakness: it is not too strong, it is especially in the area of muscles innervated by lower part of brachial plexus10 , and therefore we do not meet it at the examination of the shoulder girdle

 

vascular problems

  1. an oedema of the periphery of the limb

  2. a weakness of pulse, reduction of the temperature of hands

  3. cyanosis, Raynaud phenomenon, possibility of ulceration of fingers

  4.  an enlargement of veins (sometimes)

  5. systolic murmur in the supraclavicular area

 

 

Differential Diagnostics of Thoracic Outlet Syndrome

  1. an illness with an affection of motor neuron of medullary lower segments C of the spine11 and roots of nerves in this localisation12

  2. plexopathy or sec. affection of plexus at tumour Pancoast tumour

  3. a compression of peripheral nerves:

n. ulnaris

n. medianus13

 

10this plexus innervates mainly muscles of thenar, hypothenar and forearm

11tumours of C spine, syringomyelia, arachnoiditis

12radicular sy of the root C7, 8, Th 1 at the prolapsus of disc

13most frequent cause of the problems which is tunelessly interpreted as thoracic outlet syndrome