Presentation
Five patients presented with an ischemic upper extremity without thrombosis and underwent transaxillary first rib and cervical rib resection. [ncbi.nlm.nih.gov]
[…] plexopathy, caused by compromise of the distal C8 anterior primary ramus or proximal lower trunk fibers by a congenital band extending from a rudimentary cervical rib to the first thoracic rib; rare disorder, found mostly in young to middle-aged women, which presents [medical-dictionary.thefreedictionary.com]
A concurrent neurologic workup strongly suggested that her headache at initial presentation was a migraine and unrelated to ischemia. [omicsonline.org]
Material and Methods We present series of 8 patients operated by two consultants in our department. All patients presented with symptoms of thoracic outlet syndrome of varying intensity. [pubs.sciepub.com]
Cervical rib with stroke as the initial presentation. Neurol India. 2010;58(4):645‒647. Jusufovic M, Sandset EC, Popperud TH, et al. [medcraveonline.com]
Entire Body System
- Arm Pain
From WikiCNS Rare entity associated with upper extremity weakness (atrophy of the thenar eminence), arm pain (medial forearm), and cervical ribs Occurs typically in young and middle aged females Symptoms due to compressive fibrous band, continuous with [prod.wiki.cns.org]
Snapshot A 25-year-old woman with no history of trauma presents with right arm pain. She reports that her right arm is easily fatigable, especially after she cooks. [medbullets.com]
If the patient has a reproduction of arm pain or numbness, consider thoracic outlet syndrome. Radial artery palpation can also diminish in addition to this. [boneandspine.com]
The patient may have pain radiating along the nerves of the arm or pain in the neck and shoulder. At times this may be severe causing patient to have a severe burning type of pain along the arm. [doctor.ndtv.com]
Thoracic outlet syndrome symptoms include neck pain, shoulder pain, arm pain, numbness and tingling of the fingers, and impaired circulation to the extremities (causing discoloration). [medicinenet.com]
Cardiovascular
- Decreased Radial Pulse
Interpretation - Positive test finding ( Decreased Radial Pulse and/or Distal extremity pain reproduced ) suggests interscalene compression. [physiotherapy-treatment.com]
- Water Hammer Pulse
Immediately proximal to the dilatation, a water hammer pulse was dopplered, with loss of pulse in the artery distal to the rib extending into the axillary artery. [omicsonline.org]
Musculoskeletal
- Shoulder Pain
Thoracic outlet syndrome symptoms include neck pain, shoulder pain, arm pain, numbness and tingling of the fingers, and impaired circulation to the extremities (causing discoloration). [medicinenet.com]
In 1993, he progressively developed shoulder and arm pain along with numbness of upper limb down to 4th and 5th digits. He had gained 10 kgs since the operation. [medschool.lsuhsc.edu]
A great number of subjects with CTS presented with history of neck and shoulder pain suggestive of TOS. 61 Histopathological studies, on human cadavers, had demonstrated the structural changes induced by cervical rib compression in the lower trunk of [medcraveonline.com]
- Arm Weakness
The one exception is that people who have an extra rib (cervical rib) plus arm weakness and atrophy of hand muscles usually have abnormal nerve tests indicating ulnar nerve abnormalities. [rarediseases.org]
Symptoms include Spasm of vessels of hand leading to pallor in one or more of fingers Thrombosis or embolism of the arteries leading to weak or no pulse in the affected arm, cold fingers, hands or arms Weakness of arm or neck Aneurysm Muscle atrophy, [boneandspine.com]
A, In a patient with a history of breast cancer surgery and radiation treatment with right-arm weakness, axial T2WI shows diffuse thickening of the right PBL with no associated hyperintensity ( arrow ). [ajnr.org]
Face, Head & Neck
- Facial Numbness
Prior to this she reports no prior history of stroke symptoms, facial numbness, headache, clotting or bleeding disorders. She had a history of irritable bowel syndrome and left ulnar neuropathy, for which she was taking hyoscyamine and gabapentin. [omicsonline.org]
Urogenital
- Vaginal Bleeding
One of the first warning signs of cervical cancer is vaginal bleeding between menstrual periods, after coitus, or after menopause is established. There may also be increased vaginal discharge. [medical-dictionary.thefreedictionary.com]
- Vaginal Discharge
One of the first warning signs of cervical cancer is vaginal bleeding between menstrual periods, after coitus, or after menopause is established. There may also be increased vaginal discharge. [medical-dictionary.thefreedictionary.com]
Neurologic
- Numbness of the Hand
Symptoms include weakness or numbness of the hand; decreased size of hand muscles, which usually occurs on one side of the body; and/or pain, tingling, prickling, numbness and weakness of the neck, chest, and arms. [my.clevelandclinic.org]
- Cervicobrachial Syndrome
( Q77.2 ) cervical or first Q76.5 (syndrome) Syndrome - see also Disease cervical (root) M53.1 ICD-10-CM Diagnosis Code M53.1 Cervicobrachial syndrome 2016 2017 2018 2019 Billable/Specific Code Type 2 Excludes cervical disc disorder ( M50.- ) thoracic [icd10data.com]
- Dropping Things
(b) Tendency of dropping things from the hand. (c) Wasting of palmar muscles; either thenar or hypothenar or interossei muscles. Vascular Symptoms (a) Cold and clumsy extremities, particularly the fingers. [physiotherapy-treatment.com]
Workup
A concurrent neurologic workup strongly suggested that her headache at initial presentation was a migraine and unrelated to ischemia. [omicsonline.org]
An evaluation of the probability of malignant causes and the effectiveness of physicians’ workup. J Fam Pract. 1988;27:373–6. [balancechiropracticva.com]
X-Ray
- Mediastinal Shift
The backward displaced manubrium and body of the sternum (not displayed) splay apart the right and left brachiocephalic veins (BRV), shifting the mediastinal contents to the left of midline accentuating the mediastinal shift of the great vessels, including [mdmag.com]
Treatment
The surgery combined with anticoagulation treatment can improve the treatment outcome of ATOS. PMC Free PDF PMC Free Full Text FREE Publisher Full Text Thirty-Day Outcomes Following Surgical Decompression of Thoracic Outlet Syndrome. [unboundmedicine.com]
Medical treatment Anti-inflammatory drugs and analgesics are provided as a conservative means of treatment. [physiotherapy-treatment.com]
What is the treatment for thoracic outlet syndrome? Treatment depends on the underlying cause. [patient.info]
and found no randomized evidence that either treatments is better than no treatment at all. [emedicine.medscape.com]
Patient Population: Prevalence and Epidemiology Knee // Shoulder & Elbow // Hip // Spine // Foot & Ankle // Hand & Wrist Fragility Fractures: Diagnosis and Treatment Shoulder & Elbow The Characteristics of Surgeons Performing Total Shoulder Arthroplasty [mdedge.com]
Prognosis
What is the outlook (prognosis) for thoracic outlet syndrome? In most people with thoracic outlet syndrome, the outlook is generally good and symptoms often improve over time. [patient.info]
Etiology
A significant variable in results was the etiology of the symptoms. [ncbi.nlm.nih.gov]
[…] thoracic outlet the thoracic outlet is above the first rib and behind the clavicle classified into three types neurogenic (compression of brachial plexus) arterial (obstruction in arteries) venous (obstruction in veins) Epidemiology demographics adults Etiology [medbullets.com]
[…] the problem - there are often 1 or more congenital anomalies that predispose someone to sxs • Accurate diagnosis is based on total clinical picture - dx based on clinical exam, electrodiagnostic studies, arterial and venous studies, and x-rays • Bony etiology [quizlet.com]
[…] neurovascular disorder resulting from compression of the brachial plexus and/or subclavian vessels in the interval between the neck and axilla treatment may be nonoperative or include surgical decompression or a vascular procedure depending on the specific etiology [orthobullets.com]
[…] in 2013 who reported a case of osteoid osteoma of the 1 st rib and case presented as thoracic outlet syndrome. [ 3 ] In 2009 White PW et al discussed in detail the cervical rib causing the arterial type of TOS with subclavian artery compression and etiology [pubs.sciepub.com]
Epidemiology
Patient Population: Prevalence and Epidemiology Knee // Shoulder & Elbow // Hip // Spine // Foot & Ankle // Hand & Wrist Fragility Fractures: Diagnosis and Treatment Shoulder & Elbow The Characteristics of Surgeons Performing Total Shoulder Arthroplasty [mdedge.com]
[…] vessels as it passes through the thoracic outlet the thoracic outlet is above the first rib and behind the clavicle classified into three types neurogenic (compression of brachial plexus) arterial (obstruction in arteries) venous (obstruction in veins) Epidemiology [medbullets.com]
[…] disorder resulting from compression of the brachial plexus and/or subclavian vessels in the interval between the neck and axilla treatment may be nonoperative or include surgical decompression or a vascular procedure depending on the specific etiology Epidemiology [orthobullets.com]
Discu ssion : [ Epidemiology | Clinical Presentation | Clinical Examination | Diagnostic Management | Therapeutic Management] Epide miology: TOS commonly develops during the 3rd or 4th decade, more often in women, under the combination of a peculiar cervical [medschool.lsuhsc.edu]
[…] physiopathology of neurologic TOS consists of disturbed functionality (the conduction speed of the nervous impulse decreases) and disturbed neuronal trophicity (reversible or irreversible degenerescence). 18,19 TOS clinical features ( Tables 5-8 ) Although epidemiologically [tmj.ro]
Pathophysiology
[…] who reported a case of osteoid osteoma of the 1 st rib and case presented as thoracic outlet syndrome. [ 3 ] In 2009 White PW et al discussed in detail the cervical rib causing the arterial type of TOS with subclavian artery compression and etiology, pathophysiology [pubs.sciepub.com]
[…] population demographics females > males (3:1) tend to be thin with long necks and drooping shoulders age 20-60 type neurogenic is most common (95%) vascular may be venous (4%) or arterial (< 1%) more common in athletic males compared to athletic females Pathophysiology [orthobullets.com]
Prevention
Screening and prevention of colorectal cancer Source: Finnish Medical Society Duodecim This article is freely available only to users in the UK. [evidence.nhs.uk]
Is it possible to prevent thoracic outlet syndrome? It's possible to prevent thoracic outlet syndrome by maintaining relaxed tissues of the upper chest. [medicinenet.com]
The need of early detection of lesions caused by emboli at an early stage is extremely important to prevent the adverse vascular events. [pjmhsonline.com]
If you develop blood clots you may be prescribed thrombolytics to break them up, and anticoagulants to prevent further clots developing. If these treatments don't help, surgery may be an option. [nhs.uk]
Once the clot has been removed, your surgeon may recommend that the first rib be removed so that the narrow space through which the vein passed can be enlarged to prevent the vein from clotting again. [neuropaxclinic.com]