Radiographic Imaging in Diagnosis and Assessment of NTOS

  • Scott Werden


The clinical diagnosis of NTOS remains controversial and challenging. Fortunately, modern medical imaging, particularly MRI, provides excellent evaluation of the brachial plexus, the surrounding soft tissues and bones, and the dynamic changes that occur in the thoracic outlet on movement of the upper extremity. This chapter details the imaging anatomy of the thoracic outlet, including the component anatomic tunnels that comprise the thoracic outlet, the brachial plexus, and the dynamic changes of the thoracic outlet seen on movement of the upper extremity. Imaging findings of NTOS, as defined by pathologic entrapment of the brachial plexus, are demonstrated and defined, including soft tissue anomalies, bony anomalies, and pathologic dynamic changes that cause narrowing of the anatomic tunnels of the thoracic outlet and resultant entrapment of the brachial plexus. A simple and straightforward algorithm for reviewing an imaging study of a patient with TOS is provided. The reader will understand the important anatomic landmarks and tunnels of the thoracic outlet, the soft tissue or bony anomalies and pathologic changes that occur in the thoracic outlet, and the difference between normal and abnormal changes that occur on movement of the upper extremity, along with the resulting entrapment of the brachial plexus.


Brachial Plexus Coracoid Process Developmental Anomaly Thoracic Outlet Syndrome Bony Abnormality 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


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© Springer-Verlag London 2013

Authors and Affiliations

  1. 1.Vanguard Specialty ImagingSunnyvaleUSA

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