Thoracic outlet syndrome - arterial
Diagnosis certain
Updates to Case Attributes
Title
was changed:
Thoracic outlet syndrome diagnosed using dynamic contrast MR angiography
Status
changed from pending review to published (public).
Published At
was set to
.
Body
was changed:
ThoracicArterial thoracic outlet syndrome is a rare condition with congenital and acquired causes.
Congenital causes:
-
Cervicalcongenital causes:- cervical rib
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Aberrantaberrant scalenus anterior or intermedius muscles or fibrous bands relating to the muscles -
Bonybony compression from abnormal transverse process, clavicle or osteochondroma
-
Acquiredaquired causes:-
Tumourtumour / metastatic deposit -
Traumatrauma -
Infectioninfection (compression from abscess)
-
Radiological Investigationinvestigation
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Cervicalcervical spine radiographs -
Supplementarysupplementary thoracic outlet view to clarify presence of cervical ribs - MR or CT angiography in the arms up and down positions
Frequently these investigations follow more common MR C-Spine for presumed radicular cause of the patients symptoms. In some cases, the findings can be confounding due to the high prevalence of disc osteophyte disease in the background population.
-<p>Thoracic outlet syndrome is a rare condition with congenital and acquired causes.</p><p><strong>Congenital causes</strong></p><ul>-<li>Cervical rib</li>-<li>Aberrant scalenus anterior or intermedius muscles or fibrous bands relating to the muscles</li>-<li>Bony compression from abnormal transverse process, clavicle or osteochondroma</li>-</ul><p><strong>Acquired causes</strong></p><ul>-<li>Tumour / metastatic deposit</li>-<li>Trauma</li>-<li>Infection (compression from abscess)</li>-</ul><p><strong>Radiological Investigation</strong></p><ol>-<li>Cervical spine radiographs</li>-<li>Supplementary thoracic outlet view to clarify presence of cervical ribs</li>- +<p>Arterial thoracic outlet syndrome is a rare condition with congenital and acquired causes:</p><ul>
- +<li>
- +<strong>congenital causes:</strong><ul>
- +<li>cervical rib</li>
- +<li>aberrant scalenus anterior or intermedius muscles or fibrous bands relating to the muscles</li>
- +<li>bony compression from abnormal transverse process, clavicle or osteochondroma</li>
- +</ul>
- +</li>
- +<li>
- +<strong>aquired causes:</strong><ul>
- +<li>tumour / metastatic deposit</li>
- +<li>trauma</li>
- +<li>infection (compression from abscess)</li>
- +</ul>
- +</li>
- +</ul><p><strong>Radiological investigation</strong></p><ol>
- +<li>cervical spine radiographs</li>
- +<li>supplementary thoracic outlet view to clarify presence of cervical ribs</li>
-</ol><p>Frequently these investigations follow more common MR C-Spine for presumed radicular cause of the patients symptoms. In some cases the findings can be confounding due to the high prevalence of disc osteophyte disease in the background population.</p>- +</ol><p>Frequently these investigations follow more common MR C-Spine for presumed radicular cause of the patients symptoms. In some cases, the findings can be confounding due to the high prevalence of disc osteophyte disease in the background population.</p>
References changed:
- 1. Ersoy H, Steigner ML, Coyner KB et-al. Vascular thoracic outlet syndrome: protocol design and diagnostic value of contrast-enhanced 3D MR angiography and equilibrium phase imaging on 1.5- and 3-T MRI scanners. AJR Am J Roentgenol. 2012;198 (5): 1180-7. <a href="http://dx.doi.org/10.2214/AJR.11.6417">doi:10.2214/AJR.11.6417</a> - <a href="http://www.ncbi.nlm.nih.gov/pubmed/22528911">Pubmed citation</a><span class="ref_v3"></span>
- 1. Ersoy H, Steigner ML, Coyner KB et-al. Vascular thoracic outlet syndrome: protocol design and diagnostic value of contrast-enhanced 3D MR angiography and equilibrium phase imaging on 1.5- and 3-T MRI scanners. AJR Am J Roentgenol. 2012;198 (5): 1180-7. <a href="http://dx.doi.org/10.2214/AJR.11.6417">doi:10.2214/AJR.11.6417</a> - <a href="http://www.ncbi.nlm.nih.gov/pubmed/22528911">Pubmed citation</a><span class="ref_v3"></span>
- 2. Raptis CA, Sridhar S, Thompson RW et-al. Imaging of the Patient with Thoracic Outlet Syndrome. Radiographics. 2016;36 (4): 984-1000. <a href="http://dx.doi.org/10.1148/rg.2016150221">doi:10.1148/rg.2016150221</a> - <a href="http://www.ncbi.nlm.nih.gov/pubmed/27257767">Pubmed citation</a><span class="auto"></span>
- Ersoy H et al. Vascular Thoracic Outlet Syndrome: Protocol Design and Diagnostic Value of ContrastEnhanced 3D MR Angiography and Equilibrium Phase Imaging on 1.5- and 3-T MRI Scanners. AJR 2012; 198:1180–1187
- Ersoy H, Steigner ML, Coyner KB et-al. Vascular thoracic outlet syndrome: protocol design and diagnostic value of contrast-enhanced 3D MR angiography and equilibrium phase imaging on 1.5- and 3-T MRI scanners. AJR Am J Roentgenol. 2012;198 (5): 1180-7. <a href="http://dx.doi.org/10.2214/AJR.11.6417">doi:10.2214/AJR.11.6417</a> - <a href="http://www.ncbi.nlm.nih.gov/pubmed/22528911">Pubmed citation</a><span class="ref_v3"></span>
Updates to Study Attributes
Findings
was changed:
Technique
Contrast enhanced MR angiography in arms up and down positions using 2 separate Gadolinium contrast bolus injections.
Arms Down
Normal contrast flow through the subclavian arteries
Arms Up
Focal occlusion to contrast flow at the level of both scalenus muscles, more severe on the right. The patient is right handed-handed and has more pronounced right sided-sided symptoms.
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