Thoracic outlet syndrome
Upper limb ischemia , numbness on abduction
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The study was performed with the arm down by the patient’s side and repeated with it raised above the patient’s head. There is a string-like narrowing of the right subclavian artery ( arrows ) due to the right cervical rib when arm is raised.
Compare the artery caliber with arm aside ( yellow arrow ) to it with arm raised (red arrow )
Thoracic outlet syndrome is the term refers to compression of the neurovascular bundle at the thoracic inlet (the term ‘thoracic outlet syndrome’ is a misnomer). The syndrome can be classified into three subgroups: venous, arterial and nervous.
It is treated by resection of the cervical rib or fibrous band that is causing the problem. Thrombolysis could be considered in acute thrombosis.
Key points : Thoracic outlet syndrome occurs at one of three sites: (a) the interscalene space (just above the medial first anterior rib); (b) the costoclavicular triangle; (c) the subcoracoid space.
A Pancoast tumor can result in similar symptoms and should be excluded.