Causes of thoracic outlet syndrome
- Cervical rib
- Long C7 transverse process
- Anomalous insertion of scalene muscles
- Scalene muscle hypertrophy
- Scalene minimus
- Abnormal bands and ligaments
- Fracture clavicle or first rib
- Exostosis
- Tumours in the region
Types of compromise
Could be all of them at once
Arterial compromise
- Fatigue
- Weakness
- Coldness
- Upper limb claudication
- Thrombosis
- Paraesthesia
- Raynaud’s phenomenon due to thrombosis with distal embolisation
Venous compromise
- Edema
- Venous distension
- Collateral formation
- Cyanosis
- Paget-Schroetter syndrome – effort thrombosis
Neural compromise
- Paraesthesia
- Pain in shoulder, arm, forearm and fingers
- Occipital headache – referred from tight scalene muscles
- Weakness of forearm, hand
Thoracic Outlet Syndrome
