![]() ![]() Thoracic outlet syndrome can present in specific athletes that engage in repetitive motions that involve extreme abduction and external rotation such as competitive swimmers. Tumors or cysts in the thoracic outlet can also increase pressure, thus generate the symptoms seen in TOS. ![]() Soft tissue components are also major contributors to TOS. There was also a case reported of bilateral TOS with a patient found to have bilateral cervical ribs inducing physicians to conclude the primary cause was the anatomic abnormality. Neck trauma preceded 80% of the total cases of neuro TOS, and this lead investigators to determine the remaining 20% were caused primarily by the anatomic variant. In a review of 47 neuro TOS operations involving abnormal ribs, 85% of the cases involved cervical ribs. Cervical ribs, extra ribs typically arising from the seventh cervical vertebrae, is one of the most common offenders for thoracic outlet syndrome. ![]() Anatomic abnormalities are likely culprits for this increased pressure in the region. It manifests due to the compression of various structures in the thoracic outlet. The cause of thoracic outlet syndrome (TOS), conceptually, is straightforward. Patients who are treated appropriately generally fair well, with the vast majority having their symptoms resolve completely. Both nonsurgical and surgical treatment methods are options for patients in managing this condition. Electrodiagnostic studies can also be useful if the condition is neurologic in origin. Imaging of the musculature and vasculature can help identify this condition. Patients present with a wide range of symptoms, from minor complaints to debilitating manifestations. The first rib, scalene muscles, and the clavicle comprise the thoracic outlet. Wilbourne suggests five different types of TOS a venous variant, arterial, a traumatic, a true neurogenic, and a disputed neurogenic. TOS was first reported by Rogers in 1949 and more precisely characterized by Rob and Standeven in 1958. Thoracic outlet syndrome (TOS) is a nonspecific diagnosis representing many conditions that involve the compression of the neurovascular structures that pass through the thoracic outlet. ![]()
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