Thoracic outlet syndrome: wide literature for few cases. Status of the art
- 1.3k Downloads
Despite its low prevalence and incidence, considerable debate exists in the literature on thoracic outlet syndrome (TOS). From literature analysis on nerve entrapments, we realized that TOS is the second most commonly published entrapment syndrome in the literature (after carpal tunnel syndrome) and that it is even more reported than ulnar neuropathy at elbow, which, instead, is very frequent. Despite the large amount of articles, there is still controversy regarding its classification, clinical picture, diagnostic objective findings, diagnostic modalities, therapeutical strategies and outcomes. While some experts believe that TOS is underrated, overlooked and very frequent, others even doubt its existence as a nosological entity. In the attempt to shed more light on this condition, we performed a systematic review of the literature and report evidence and opinions around this controversial subject. Only articles focused on neurogenic TOS were considered. Understanding the status of the art and the underlying reasons of doubts and weaknesses could help clinical practice and set the stage for future research.
KeywordsThoracic outlet syndrome Nerve entrapments Brachial plexus Literature review Neuropathy Neurogenic TOS
Compliance with ethical standards
Conflict of interest
There are no conflicts of interest to declare.
- 10.Demirbag D, Unlu E, Ozdemir F, Genchellac H, Temizoz O, Ozdemir H, Demir MK (2007) The relationship between magnetic resonance imaging findings and postural maneuver and physical examination tests in patients with thoracic outlet syndrome: results of a double-blind, controlled study. Arch Phys Med Rehabil 88(7):844–851CrossRefPubMedGoogle Scholar
- 14.Buller LT, Jose J, Baraga M, Lesniak B (2015) Thoracic outlet syndrome: current concepts, imaging features, and therapeutic strategies. Am J Orthop (Belle Mead NJ) 44(8):376–382Google Scholar
- 17.Moriarty JM, Bandyk DF, Broderick DF, Cornelius RS, Dill KE, Francois CJ, Gerhard-Herman MD, Ginsburg ME, Hanley M, Kalva SP, Kanne JP, Ketai LH, Majdalany BS, Ravanel JG, Roth CJ, Saleh AG, Schenker MP, Mohammed TL, Rybicki FJ (2015) ACR appropriateness criteria imaging in the diagnosis of thoracic outlet syndrome. J Am Coll Radiol 12(5):438–443. doi: 10.1016/j.jacr.2015.01.016 CrossRefPubMedGoogle Scholar
- 41.Paraskevas G, Ioannidis O, Papaziogas B, Natsis K, Spanidou S, Kitsoulis P (2007) An accessory middle scalene muscle causing thoracic outlet syndrome. Folia Morphol (Warsz) 66(3):194–197Google Scholar