Thoracic Outlet Syndrome

ALL SHOULDER girdle compression syndromes have one problem in common 1 ; compression of the brachial plexus and the subclavian artery and vein, usually between the clavicle and first rib (Fig 1). Grouping the separate syndromes under the single heading of thoracic outlet syndrome 2 has allowed more accurate diagnostic and therapeutic measures to be established. Therefore, this syndrome should be considered in all neurologic and vascular complaints of the upper extermities: 1. Scalenus anticus 2. Hyperabduction 3. Costoclavicular 4. Cervical rib 5. Fractured clavicle 6. Cervicobrachial compression 7. Pneumatic hammer 8. Effort vein thrombosis 9. Subcoracoid pectoralis minor 10. First thoracic rib Symptoms Symptoms may be grouped into neurologic and vascular complaints. The most common neurologic symptom is aching pain in the side of back of the neck and extending across the shoulder and down the arm. The pain may radiate in all directions from the point of compression. Numbness