Thoracic-outlet syndrome G54.0

Thoracic-outlet syndrome, also known as upper thoracic outlet syndrome, is defined as an anatomical narrowing of the upper thoracic opening in the region between the collarbone and the upper rib. The causes are:

• Cervical rib
• Scalenus-anterior syndrome (narrow scalenus muscle triangle)
• Costoclavicular syndrome (tightness between the 1st rib and clavicle in abduction of the arm)
• Hyperabduction syndrome (tendon of the minor pectoralis tendon leads to compression of the vascular nerve sheath during abduction)
• Callus formation after clavicle fracture.

in an American collective, the frequency of cervical rib syndrome was about 0.06%. About 50% of patients were symptomatic. f>m

In a larger study, the age of onset of the disease was between 30 and 40 years.

Clinically, this is a compression of the artery, vein or nerve at the point where these structures leave the bony thorax.

Symptoms are paresthesias, acute circulatory disorders and pulselessness of the affected arm during certain movements in the shoulder joint, especially when lifting (overhead work) or abducting the arm. Intermittent shoulder-arm pain,

Provocation test with the defendant manoeuvre: passive pulling down of the shoulder to the rear (Eden manoeuvre), arm elevation and external rotation (Wright manoeuvre). Dupex sonography, angiography, MR angiography,

Deep vein thrombosis of the arm

Surgical correction is only carried out in the event of significant complaints (cervical rib removal, resection of the first rib, removal of the callus formed).

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3. Raptis CA et al (2016) Imaging of the Patient with Thoracic Outlet Syndrome. Radiographics 36:984-1000.
4. Sidoff L et al (2016) Eradication by Irradiation: Osteoid Osteoma Presenting as Thoracic Outlet Syndrome. On J Phys Med Rehabilitation 95:e131-132.