Chang MC, Kim DH. Essentials of thoracic outlet syndrome: A narrative review. World J Clin Cases 2021; 9(21): 5804-5811 [PMID: 34368299 DOI: 10.12998/wjcc.v9.i21.5804]
Corresponding Author of This Article
Du Hwan Kim, MD, PhD, Associate Professor, Department of Physical Medicine and Rehabilitation, College of Medicine, Chung-Ang University, 102, Heukseok-ro, Dongjak-gu, Seoul 06973, South Korea. ri-pheonix@hanmail.net
Research Domain of This Article
Rehabilitation
Article-Type of This Article
Minireviews
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Clin Cases. Jul 26, 2021; 9(21): 5804-5811 Published online Jul 26, 2021. doi: 10.12998/wjcc.v9.i21.5804
Essentials of thoracic outlet syndrome: A narrative review
Min Cheol Chang, Du Hwan Kim
Min Cheol Chang, Department of Rehabilitation Medicine, College of Medicine, Yeungnam University, Daegu 42415, South Korea
Du Hwan Kim, Department of Physical Medicine and Rehabilitation, College of Medicine, Chung-Ang University, Seoul 06973, South Korea
Author contributions: Kim DH and Chang MC contributed to the concept of the research; Kim DH and Chang MC drafted the manuscript; all authors read and approved the final version of the manuscript.
Conflict-of-interest statement: The authors declare no conflict of interest.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Du Hwan Kim, MD, PhD, Associate Professor, Department of Physical Medicine and Rehabilitation, College of Medicine, Chung-Ang University, 102, Heukseok-ro, Dongjak-gu, Seoul 06973, South Korea. ri-pheonix@hanmail.net
Received: March 22, 2021 Peer-review started: March 22, 2021 First decision: April 29, 2021 Revised: May 6, 2021 Accepted: May 24, 2021 Article in press: May 24, 2021 Published online: July 26, 2021
Abstract
Thoracic outlet syndrome (TOS) is a group of diverse disorders involving compression of the nerves and/or blood vessels in the thoracic outlet region. TOS results in pain, numbness, paresthesia, and motor weakness in the affected upper limb. We reviewed the pathophysiology, clinical evaluation, differential diagnoses, and treatment of TOS. TOS is usually classified into three types, neurogenic, venous, and arterial, according to the primarily affected structure. Both true neurogenic and disputed TOS are considered neurogenic TOS. Since identifying the causative lesions is complex, detailed history taking and thorough clinical investigation are needed. Electrodiagnostic and imaging studies are helpful for excluding other possible disorders and confirming the diagnosis of true neurogenic TOS. The existence of a disputed TOS remains controversial. Neuromuscular physicians tend to be skeptical about the existence of disputed TOS, but thoracic surgeons argue that disputed TOS is under-diagnosed. Clinicians who encounter patients with TOS need to understand its key features to avoid misdiagnosis and provide appropriate treatment.
Core Tip: Thoracic outlet syndrome (TOS) is a group of disorders involving compression of the nerves and/or blood vessels in the thoracic outlet region. TOS is classified into three types, neurogenic, venous, and arterial, according to the primarily affected structure. In true neurogenic TOS, the T1 nerve root is more susceptible to damage than the C8 nerve root. The disputed TOS is categorized as a type of neurogenic TOS, but the diagnostic criteria for disputed TOS are lacking and controversial. Before confirming a diagnosis of disputed TOS, clinicians should exclude all other disorders that share common symptoms and features with disputed TOS.
