View source for Thoracic outlet syndrome

<section begin="orthopaedics" />* Symptoms occurring due to compression of structures like
** Brachial plexus (95% of cases)
** Subclavian vein (4% of cases)
** Subclavian artery (1% of cases)
* Caused by narrowing of the anatomical opening called “thoracic inlet”, “thoracic outlet” or “superior thoracic aperture”, which is a hole surrounded by
** Clavicula
** The first rib
** Scalenus anterior
** Scalenus medius
* If the thoracic outlet becomes narrower some or all of the neurovascular structures may be compressed
* Etiology
** Trauma
*** Collarbone fracture
** Hypertrophy of scalenus muscles
** Pancoast tumor
** Congenital cervical (extra) rib
* Clinical features
** Neurogenic thoracic outlet syndrome
*** Due to compression of brachial plexus
*** Pain, anaesthesia, paraesthesia in neck and arm
*** Often in areas innervated by ulnar nerve
** Venous thoracic outlet syndrome
*** Due to compression of subclavian vein
*** Swelling
*** Venous distension
*** Venous thrombosis
** Arterial thoracic outlet syndrome
*** Due to compression of subclavian artery
*** 4 Ps
**** Pulselessness (in the hand)
**** Pain
**** Pallor
**** Paraesthesia
* Treatment
** Physical therapy
*** In mild cases, can be enough
** Thoracic outlet decompression surgery
*** Transaxillary resection of extra rib or first rib
*** Angioplasty, if vessels are affected
* Cervical rib
** Some people have a congenital extra rib before the first rib called the cervical rib
*** The first rib starts at Th1
*** The cervical rib starts at C7
** This cervical rib compresses the thoracic outlet, causing TOS
** The treatment is surgical resection of the cervical rib<section end="orthopaedics" />
[[Category:Vascular surgery]]
[[Category:Orthopaedics]]