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    Clinical presentation and management of arterial thoracic outlet syndrome.
    J Vasc Surg 2017 Feb 8. Epub 2017 Feb 8.
    Center for Thoracic Outlet Syndrome and the Section of Vascular Surgery, Department of Surgery, Washington University in St. Louis School of Medicine, St. Louis, Mo. Electronic address:
    Objective: Arterial thoracic outlet syndrome (TOS) is a rare condition characterized by subclavian artery pathology associated with a bony abnormality. This study assessed contemporary clinical management of arterial TOS at a high-volume referral center.

    Methods: A prospectively maintained database was used to conduct a retrospective review of patients undergoing primary or reoperative treatment for arterial TOS during an 8-year period (2008 to 2016). Read More

    Residual Symptom Analysis After the Subtotal Anterior and Middle Scalenectomy for Disputed Thoracic Outlet Syndrome: Comparison Between Surgical and Untreated Patients.
    Ann Plast Surg 2017 Feb 10. Epub 2017 Feb 10.
    From the Department of Hand Surgery, The First Hospital of Ji Lin University, Chang Chun, 130021, China.
    Objective: There are significant differences in the results on disputed thoracic outlet syndrome (TOS) surgery, which reflect that not all patients with disputed TOS are amenable to surgery. It is necessary to find out appropriate indicators for screening of patients who are suitable for surgery. Pain and paresthesia are 2 prominent symptoms of disputed TOS. Read More

    Evaluation of Complications after Surgical Treatment of Thoracic Outlet Syndrome.
    Korean J Thorac Cardiovasc Surg 2017 Feb 5;50(1):36-40. Epub 2017 Feb 5.
    Department of General Surgery, Emam Hosein Hospital, Shahid Beheshti University of Medical Sciences.
    Background: Surgical treatment of thoracic outlet syndrome (TOS) is necessary when non-surgical treatments fail. Complications of surgical procedures vary from short-term post-surgical pain to permanent disability. The outcome of TOS surgery is affected by the visibility during the operation. Read More

    Osteopathic treatment in a patient with left-ventricular assist device with left brachialgia: a case report.
    Int Med Case Rep J 2017 13;10:19-23. Epub 2017 Jan 13.
    Center for Life Nano Science, CLNS@Sapienza, Istituto Italiano di Tecnologia, Rome, Italy.
    This study deals with an osteopathic approach used for a patient with left-ventricular assist device (L-VAD) affected by left brachialgia. Clinical examination revealed the presence of thoracic outlet syndrome and pectoralis minor syndrome, with compression of the left proximal ulnar nerve, related to the surgical sternotomy performed. The osteopathic techniques used can be classified as indirect and direct, addressed to the pectoralis minor and the first left rib, respectively. Read More

    An unusual case of neurogenic thoracic outlet syndrome.
    Int J Surg Case Rep 2017 Jan 17;31:139-141. Epub 2017 Jan 17.
    Dept. of General Surgery, Mahatma Gandhi Medical College and Research Institute, Sri Balaji Vidyapeeth University, Pondicherry, India. Electronic address:
    Introduction: Neurogenic thoracic outlet syndrome (nTOS) is the most common manifestation of thoracic outlet syndrome (TOS), accounting for more than 95% of cases. It is usually caused by cervical ribs, anomalies in the scalene muscle anatomy or post-traumatic inflammatory changes causing compression of the brachial plexus.

    Case Presentation: We present an unusual case of nTOS caused by a cystic lymphangioma at the thoracic outlet, with only one case reported previously in the literature. Read More

    Imaging of venous compression syndromes.
    Cardiovasc Diagn Ther 2016 Dec;6(6):519-532
    Division of Cardiovascular Imaging, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114, USA.
    Venous compression syndromes are a unique group of disorders characterized by anatomical extrinsic venous compression, typically in young and otherwise healthy individuals. While uncommon, they may cause serious complications including pain, swelling, deep venous thrombosis (DVT), pulmonary embolism, and post-thrombotic syndrome. The major disease entities are May-Thurner syndrome (MTS), variant iliac vein compression syndrome (IVCS), venous thoracic outlet syndrome (VTOS)/Paget-Schroetter syndrome, nutcracker syndrome (NCS), and popliteal venous compression (PVC). Read More

    Sonographic tracking of trunk nerves: essential for ultrasound-guided pain management and research.
    J Pain Res 2017 4;10:79-88. Epub 2017 Jan 4.
    Department of Physical and Rehabilitation Medicine, Hacettepe University Medical School, Ankara, Turkey.
    Delineation of architecture of peripheral nerves can be successfully achieved by high-resolution ultrasound (US), which is essential for US-guided pain management. There are numerous musculoskeletal pain syndromes involving the trunk nerves necessitating US for evaluation and guided interventions. The most common peripheral nerve disorders at the trunk region include thoracic outlet syndrome (brachial plexus), scapular winging (long thoracic nerve), interscapular pain (dorsal scapular nerve), and lumbar facet joint syndrome (medial branches of spinal nerves). Read More

    Dorsal Scapular Artery Variations and Relationship to the Brachial Plexus, and a Related Thoracic Outlet Syndrome Case.
    J Brachial Plex Peripher Nerve Inj 2016 10;11(1):e21-e28. Epub 2016 May 10.
    Department of Anatomy and Cell Biology, Temple University School of Medicine, Philadelphia, Pennsylvania, United States.
    Rationale Knowledge of the relationship of the dorsal scapular artery (DSA) with the brachial plexus is limited. Objective We report a case of a variant DSA path, and revisit DSA origins and under-investigated relationship with the plexus in cadavers. Methods The DSA was examined in a male patient and 106 cadavers. Read More

    Aneurysmal Bone Cyst Arising from the First Rib: A Rare Cause of Thoracic Outlet Syndrome.
    Thorac Cardiovasc Surg Rep 2016 Dec 16;5(1):74-76. Epub 2015 Dec 16.
    Department of Cardiothoracic Surgery, New York Presbyterian Hospital, New York, New York, United States.
    Aneurysmal bone cyst is a rare benign cystic bone lesion with an incidence of only 0.14 per 100,000 individuals and most commonly affects the metaphyses of long bones, spine, and pelvis. We present a very rare case of a 17-year-old boy with a rapidly expanding aneurysmal bone cyst arising from the first rib, resulting in neurogenic thoracic outlet syndrome secondary to its compression of the brachial plexus. Read More

    The thoracic outlet syndromes: Part 2. The Arterial, Venous, Neurovascular, and Disputed Thoracic Outlet Syndromes.
    Muscle Nerve 2016 Dec 22. Epub 2016 Dec 22.
    Department of Internal Medicine, University of Pennsylvania, Philadelphia, Pennsylvania.
    The thoracic outlet syndromes (TOSs) are a group of etiologically and clinically distinct disorders with 1 feature in common: compression of 1 or more neurovascular elements as they traverse the thoracic outlet. The medical literature reflects 5 TOSs: arterial, venous, traumatic neurovascular, true neurogenic, and disputed. Of these, the first 4 demonstrate all of the features expected of a syndrome, whereas disputed TOS does not, causing many experts doubt its existence altogether. Read More

    The thoracic outlet syndromes: Part 1. Overview of the Thoracic Outlet Syndromes and Review of True Neurogenic Thoracic Outlet Syndrome.
    Muscle Nerve 2016 Dec 22. Epub 2016 Dec 22.
    Department of Internal Medicine, University of Pennsylvania, Philadelphia, Pennsylvania.
    The thoracic outlet syndromes (TOSs) are a group of etiologically and clinically distinct disorders with 1 feature in common: compression of 1 or more neurovascular elements as they traverse the thoracic outlet. The medical literature reflects 5 TOSs: arterial, venous, traumatic neurovascular, true neurogenic, and disputed. Of these, the first 4 demonstrate all of the features expected of a syndrome, whereas disputed TOS does not, causing many experts to doubt its existence altogether. Read More

    Botulinum Toxin Injections in Musculoskeletal Disorders.
    Semin Musculoskelet Radiol 2016 Nov 21;20(5):441-452. Epub 2016 Dec 21.
    Division of Musculoskeletal Imaging and Intervention, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts.
    Botulinum toxin (BTX) is used for multiple clinical indications due to its ability to induce temporary chemodenervation and muscle paralysis. This property has supported its application in treating a variety of musculoskeletal conditions, especially those involving muscular hyperactivity and contractures such as cerebral palsy and dystonia. However, off-label use of BTX injection in other musculoskeletal disorders is gaining increased acceptance, such as in neurogenic thoracic outlet syndrome, epicondylitis, and shoulder pain after stroke. Read More

    Modified Interscalene Approach for Resection of Symptomatic Cervical Rib: Anatomic Review and Clinical Study.
    World Neurosurg 2017 Feb 28;98:124-131. Epub 2016 Oct 28.
    Department of Anaesthesia and Intensive Care, Ain Shams University, Abbasseya, Cairo, Egypt.
    Background: Cervical ribs have been reported to be present in about 0.5% of the general population, 10% of patients with cervical rib who are symptomatic usually have neurogenic symptoms, but some have arterial symptoms. In 1861, Coote was the first to excise a cervical rib through a supraclavicular approach and relieved the symptoms of thoracic outlet syndrome. Read More

    Thoracic outlet syndrome: wide literature for few cases. Status of the art.
    Neurol Sci 2016 Dec 16. Epub 2016 Dec 16.
    Department of Geriatrics, Neurosciences and Othopaedics, Università Cattolica del Sacro Cuore, Largo F. Vito 1, 00168, Rome, Italy.
    Despite its low prevalence and incidence, considerable debate exists in the literature on thoracic outlet syndrome (TOS). From literature analysis on nerve entrapments, we realized that TOS is the second most commonly published entrapment syndrome in the literature (after carpal tunnel syndrome) and that it is even more reported than ulnar neuropathy at elbow, which, instead, is very frequent. Despite the large amount of articles, there is still controversy regarding its classification, clinical picture, diagnostic objective findings, diagnostic modalities, therapeutical strategies and outcomes. Read More

    A Fourteen-Year Experience with Vascular Anomalies Encountered during Transaxillary Rib Resection for Thoracic Outlet Syndrome.
    Ann Vasc Surg 2016 Dec 12. Epub 2016 Dec 12.
    Section of Vascular Surgery and Endovascular Therapy, Department of Surgery, University of Colorado Denver, Aurora, CO; Department of Radiology, Presbyterian/St. Luke's Medical Center, Denver, CO. Electronic address:
    Background: Transaxillary approach to first rib resection and scalenectomy (TAFRRS) is a well-established technique for treatment of thoracic outlet syndrome (TOS). Although anatomic features encountered during TAFRRS are in general constant, vascular anomalies may be encountered but have not been described to date. Herein we describe vascular abnormalities encountered during TAFRRS. Read More

    Venous Thoracic Outlet Syndrome: The Role of Early Rib Resection.
    Mil Med 2016 Nov;181(11):e1706-e1710
    Division of Vascular Surgery, Department of Surgery, Naval Medical Center San Diego, 34800 Bob Wilson Drive, San Diego, CA 92134.
    The upper extremity is an uncommon site for deep vein thrombosis and, although most of these thrombotic events are secondary to catheters or indwelling devices, venous thoracic outlet syndrome is an important cause of primary thrombosis. Young, active, otherwise healthy individuals that engage in repetitive upper extremity exercises, such as those required by a military vocation, may be at an increased risk. We present the case of a Naval Officer diagnosed with venous thoracic outlet syndrome whereby a multimodal approach with early surgical decompression was used. Read More

    [Thoracic outlet syndrome: A case of scalene muscle hypertrophy in long-term follow-up of diagnosis of cervical discopathy].
    Agri 2016 Jul;28(3):158-161
    Department of Algology, Ankara University Faculty of Medicine, Ankara, Turkey.
    Described in this article is diagnosis and treatment of mixed type of thoracic outlet syndrome (TOS) resulting from scalene muscle hypertrophy. Many diseases should be considered in the differential diagnosis to definitively diagnose this syndrome, and it is necessary to ask about activities of daily life, in addition to adding provocative tests to physical examination and examining electrophysiological and imaging results. Once diagnosed, even if complaints decrease with conservative treatment, surgery may be required. Read More

    Outcome of Surgical Treatment for Thoracic Outlet Syndrome: Systematic Review and Meta-Analysis.
    Ann Vasc Surg 2016 Sep 22. Epub 2016 Sep 22.
    Department of Vascular Surgery, St Antonius Hospital, Nieuwegein, The Netherlands. Electronic address:
    Background: Many publications report outcomes of surgical treatment for thoracic outlet syndrome (TOS); however, high-quality reviews and meta-analyses are lacking. This systematic review and meta-analysis summarizes and compares the outcomes and major complications of the surgical procedures for the 3 types of TOS: arterial, venous, and neurogenic.

    Methods: MEDLINE, EMBASE, and CINAHL databases, and the Cochrane Database of Systematic Reviews were searched for papers published between January 1980 and February 2015, using the keywords thoracic outlet syndrome, and treatment and surgical. Read More

    An Unusual Cause of Thoracic Outlet Syndrome.
    Heart Lung Circ 2016 Dec 26;25(12):e162-e164. Epub 2016 Jul 26.
    Thoracic Surgery Unit, Department of Cardiologic, Thoracic and Vascular Sciences, University of Padua, Padova, Italy.
    Thoracic outlet syndrome (TOS) is a condition arising from compression of the subclavian vessels and/or brachial plexus. Many factors or diseases may cause compression of the neurovascular bundle at the thoracic outlet. We describe the case of a 41-year-old woman with TOS who presented with vascular venous symptoms. Read More

    Magnetic resonance imaging of traumatic and non-traumatic brachial plexopathies.
    Singapore Med J 2016 Oct;57(10):552-560
    Department of Diagnostic Radiology, Khoo Teck Puat Hospital, Alexandra Health System, Singapore.
    Adult-onset brachial plexopathy can be classified into traumatic and non-traumatic aetiologies. Traumatic brachial plexopathies can affect the pre- or postganglionic segments of the plexus. Non-traumatic brachial plexopathies may be due to neoplasia, radiotherapy, thoracic outlet syndrome and idiopathic neuralgic amyotrophy. Read More

    Thoracic Outlet Syndrome in a Volleyball Player Due to Nonunion of the First Rib Fracture.
    Vasc Endovascular Surg 2016 Nov 23;50(8):563-565. Epub 2016 Oct 23.
    1 Division of Vascular Diseases and Surgery, Department of Surgery, Ohio State University College of Medicine, Ohio State University Wexner Medical Center, Columbus, OH, USA.
    Fracture of the first rib with ensuing callus formation is a rare cause of thoracic outlet syndrome. We report a case of a 17-year-old female volleyball player who presented with months of chronic arm pain. Radiographic imaging demonstrated nonunion fracture of the first rib. Read More

    Diagnosis of Paget-Schroetter Syndrome/Primary Effort Thrombosis in a Recreational Weight Lifter.
    Phys Ther 2016 Sep 1. Epub 2016 Sep 1.
    S. Jackson, PT, PhD, Department of Rehabilitation Services, Orange Park Medical Center, Orange Park, Florida.
    Background And Purpose: Paget-Schroetter syndrome (PSS) is a rare condition of vein thrombosis that can be manifested in athletes and laborers who overuse their upper extremities. If diagnosed early, PSS can be managed and the symptoms can be fully reversed. Venous duplex ultrasound (US), the modality most commonly used to diagnose deep vein thrombosis (DVT), has high sensitivity and specificity for detecting DVT. Read More

    Arterial thoracic outlet syndrome: rare and triggering.
    Minerva Cardioangiol 2016 Dec;64(6):635-641
    Cambridge Vascular Unit, Addenbrooke's Hospital, Cambridge, UK -
    Arterial thoracic outlet syndrome (TOS) is the least common type of TOS. Patient's symptoms, clinical examination and duplex ultrasonography usually suffice in deciding patient's management. Our proposed treatment strategies are based on the Scher classification. Read More

    Thoracic outlet syndromes. The so-called "neurogenic types".
    Hand Surg Rehabil 2016 Jun 11;35(3):155-164. Epub 2016 May 11.
    Hand Surgery Unit, Department of Orthopedic Surgery, Hôpital Trousseau, University Hospital of Tours, avenue de la République, 37170 Chambray-lès-Tours, France. Electronic address:
    Neurogenic thoracic outlet syndrome (TOS) is one of the most controversial pain syndromes of the upper limbs. The controversies revolve around both the diagnosis and treatment of the non-specific or subjective subtypes. Their diagnosis rests on a combination of history, suggestive symptoms and clinical examination. Read More

    Thoracic outlet syndrome affecting high-performance musicians playing bowed string instruments.
    Vascular 2016 Sep 30. Epub 2016 Sep 30.
    Division of Vascular Surgery and Endovascular Therapy, Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, TX, USA University Vascular Associates, Los Angeles, CA, USA
    Thoracic outlet syndrome, a condition due to neurovascular compression in the upper shoulder region, can be caused by chronic repetitive activity of the upper extremities. Studies have linked upper extremity musculoskeletal disorders to high-performance musicians who play bowed string instruments such as the violin or viola. We report herein a case series of five elite musicians, including three violinists and two violaists, who developed neurogenic thoracic outlet syndrome following years of intense practice. Read More

    FROM COMPLEX EVOLVING TO SIMPLE: CURRENT REVISIONAL AND ENDOSCOPIC PROCEDURES FOLLOWING BARIATRIC SURGERY.
    Arq Bras Cir Dig 2016;29Suppl 1(Suppl 1):128-133
    Center for Innovative Surgery (ZIC), Department of General, Visceral and Transplant Surgery, Campus Virchow Klinikum and Department of General, Visceral, Vascular and Thoracic Surgery, Campus Mitte, Charité-Universitätsmedizin Berlin, Berlin, Germany;
    Background:: Roux-en-Y gastric bypass (RYGB) is a standard therapy in bariatric surgery. Sleeve gastrectomy and gastric banding, although with good results in the literature, are showing higher rates of treatment failure to reduce obesity-associated morbidity and body weight. Other problems after bariatric may occur, as band erosion, gastroesophageal reflux disease and might be refractory to medication. Read More

    Thoracic Outlet Syndrome: A Significant Family Genetic Phenotypic Presentation.
    Prague Med Rep 2016;117(2-3):117-123
    Department of Cardiovascular Surgery, Second Faculty of Medicine, Charles University and University Hospital Motol, Prague, Czech Republic.
    We report on a very rare case of diagnosis and successful surgical treatment of three young family members with a four-fold presentation of thoracic outlet syndrome. In the relevant family case, we are considering and discussing the population incidence, a possible HOX genes disorder, and a significant phenotypic presentation. Read More

    Arterial thoracic outlet syndrome: rare and triggering.
    Minerva Cardioangiol 2016 Dec;64(6):637-43
    Cambridge Vascular Unit, Addenbrooke's Hospital, Cambridge, UK -
    Arterial thoracic outlet syndrome (TOS) is the least common type of TOS. Patient's symptoms, clinical examination and duplex ultrasonography usually suffice in deciding patient's management. Our proposed treatment strategies are based on the Scher classification. Read More


    Totally Endoscopic (VATS) First Rib Resection for Thoracic Outlet Syndrome.
    Ann Thorac Surg 2017 Jan 19;103(1):241-245. Epub 2016 Sep 19.
    Department of Thoracic Surgery, St. James's University Hospital, Leeds Teaching Hospitals, United Kingdom. Electronic address:
    Background: Thoracic outlet syndrome (TOS) causes neurologic symptoms in 95% of cases and vascular symptoms in 5% of cases. Surgical resection is curative. Endoscopic-assisted transaxillary first rib resection has been previously reported. Read More

    Diagnosis and treatment of effort-induced thrombosis of the axillary subclavian vein due to venous thoracic outlet syndrome.
    J Vasc Surg Venous Lymphat Disord 2016 Oct;4(4):485-500
    Center for Thoracic Outlet Syndrome, Washington University School of Medicine, St Louis, Mo; Department of Surgery (Section of Vascular Surgery), Washington University School of Medicine, St Louis, Mo; Department of Radiology, Washington University School of Medicine, St Louis, Mo. Electronic address:
    Venous thoracic outlet syndrome (VTOS) is uncommon but most frequently occurs in young, active, healthy patients. This condition typically presents as subclavian vein (SCV) effort thrombosis, also known as Paget-Schroetter syndrome. The pathophysiology underlying VTOS is chronic repetitive compression injury of the SCV in the costoclavicular space, resulting in progressive venous scarring, focal stenosis, and eventual thrombosis. Read More

    Vascular Thoracic Outlet Syndrome.
    Semin Thorac Cardiovasc Surg 2016 28;28(1):151-7. Epub 2015 Oct 28.
    Division of Vascular Surgery, Li Ka Shing Knowledge Institute of St. Michael׳s Hospital, Toronto, Ontario, Canada; Department of Surgery, University of Toronto, Ontario, Canada; King Saud University-Li Ka Shing Collaborative Research Program, Riyadh, Kingdom of Saudi Arabia; Department of Surgery, King Saud University, Riyadh, Kingdom of Saudi Arabia. Electronic address:
    Two distinct terms are used to describe vascular thoracic outlet syndrome (TOS) depending on which structure is predominantly affected: venous TOS (due to subclavian vein compression) and arterial TOS (due to subclavian artery compression). Although the venous and arterial subtypes of TOS affect only 3% and <1% of all TOS patients respectively, the diagnostic and management approaches to venous and arterial TOS have undergone considerable evolution due to the recent emergence of minimally invasive endovascular techniques such as catheter-directed arterial and venous thrombolysis, and balloon angioplasty. In this review, we discuss the anatomical factors, etiology, pathogenesis and clinical presentation of vascular TOS patients. Read More

    Reporting standards of the Society for Vascular Surgery for thoracic outlet syndrome.
    J Vasc Surg 2016 Sep;64(3):e23-35
    Section of Vascular Surgery, Washington University, St. Louis, Mo.
    Thoracic outlet syndrome (TOS) is a group of disorders all having in common compression at the thoracic outlet. Three structures are at risk: the brachial plexus, the subclavian vein, and the subclavian artery, producing neurogenic (NTOS), venous (VTOS), and arterial (ATOS) thoracic outlet syndromes, respectively. Each of these three are separate entities, though they can coexist and possibly overlap. Read More

    Reporting standards of the Society for Vascular Surgery for thoracic outlet syndrome: Executive summary.
    J Vasc Surg 2016 Sep;64(3):797-802
    Section of Vascular Surgery, Washington University, St. Louis, Mo.
    Thoracic outlet syndrome (TOS) is a group of disorders all having in common compression at the thoracic outlet. Three structures are at risk: the brachial plexus, the subclavian vein, and the subclavian artery, producing neurogenic (NTOS), venous (VTOS), and arterial (ATOS) thoracic outlet syndromes, respectively. Each of these three are separate entities, though they can coexist and possibly overlap. Read More

    Pharmacomechanical or ultrasound-assisted thrombolysis, balloon angioplasty and provisional surgical decompression for upper extremity deep vein thrombosis due to thoracic outlet syndrome.
    Thromb Res 2016 Sep 5;145:109-11. Epub 2016 Aug 5.
    Swiss Cardiovascular Center, Division of Vascular Medicine, University of Bern, University Hospital Bern, Bern, Switzerland. Electronic address:

    Venous Thoracic Outlet Syndrome as a Cause of Intractable Migraines.
    Ann Vasc Surg 2016 Aug 12. Epub 2016 Aug 12.
    Division of Vascular and Endovascular Surgery, DeWitt-Daughtry Family Department of Surgery, University of Miami Miller School of Medicine, Miami, FL.
    Thoracic outlet syndrome (TOS) refers to the compression of the neurovascular bundle within the thoracic outlet. Cases are classified by primary etiology-arterial, neurogenic, or venous. In addition to the typical symptoms of arm swelling and paresthesias, headaches have been reported as a potential symptom of TOS. Read More

    Upper extremity deep venous thrombosis and pulmonary embolus after ovarian hyperstimulation.
    BMJ Case Rep 2016 Aug 16;2016. Epub 2016 Aug 16.
    Department of Pulmonary and Critical Care, George Washington University Hospital, Washington, District of Columbia, USA.
    A healthy female presented with upper extremity (UE) swelling of several days duration. Admission laboratories were normal except for an elevated D-dimer. An UE ultrasound with Doppler revealed a thrombus in the right subclavian vein. Read More

    SCREENING FOR REFERRAL BY A SPORTS PHYSICAL THERAPIST REVEALS AN EFFORT THROMBOSIS IN A COLLEGIATE PITCHER: A CASE REPORT.
    Int J Sports Phys Ther 2016 Aug;11(4):607-13
    Western Kentucky University, Bowling Green, KY, USA.
    Background And Purpose: Screening for referral, regardless of setting, is the responsibility of all physical therapists. A serious condition that sports physical therapists may encounter is upper extremity (UE) deep venous thrombosis (DVT), which can result in the important and sometimes fatal complication of pulmonary embolism.

    Case Description: A 22 year-old male right-hand dominant collegiate pitcher was referred for physical therapist evaluation and treatment secondary to acute right UE pain and swelling. Read More

    Performance Metrics in Professional Baseball Pitchers before and after Surgical Treatment for Neurogenic Thoracic Outlet Syndrome.
    Ann Vasc Surg 2016 Aug 12. Epub 2016 Aug 12.
    Department of Vascular Surgery, Baylor University Medical Center and Texas A&M Health Sciences Center, Dallas, TX.
    Background: High-performance throwing athletes may be susceptible to the development of neurogenic thoracic outlet syndrome (NTOS). This condition can be career-threatening but the outcomes of treatment for NTOS in elite athletes have not been well characterized. The purpose of this study was to utilize objective performance metrics to evaluate the impact of surgical treatment for NTOS in Major League Baseball (MLB) pitchers. Read More

    Thoracic Outlet Syndrome: Past and Present-88 Surgeries in 30 Years at Chang Gung.
    Plast Reconstr Surg Glob Open 2016 Jun 1;4(6):e728. Epub 2016 Jun 1.
    Department of Plastic Surgery, Chang Gung Memorial Hospital, Chang Gung University, Taipei-Linkou, Taiwan.
    Background: Thoracic outlet syndrome (TOS) is a highly controversial clinical entity. There is much debate on its terminology, existence, diagnosis, and treatment. The purpose of this study was to describe our opinions about these controversial topics of TOS and the treatment of TOS over the past 30 years. Read More

    The enigma of neurogenic thoracic outlet syndrome following motor vehicle collisions.
    Can J Surg 2016 Aug;59(4):276-80
    From the Department of Surgery, University of British Columbia, Retired (Munro); and the Department of Orthopedics, University of British Columbia, Retired (McPherson).
    Background: The concept of neurogenic thoracic outlet syndrome (N-TOS) including upper and lower plexus syndromes secondary to soft tissue neck injury after motor vehicle collisions (MVCs) has been contentious. We considered that analysis of objective data from this group of patients could provide insight into this controversial type of N-TOS.

    Methods: During the 10-year period January 2001 through December 2010 we examined patients who had received a diagnosis of N-TOS following an MVC. Read More

    Ultrasonographic Identification of Fibromuscular Bands Associated with Neurogenic Thoracic Outlet Syndrome: The "Wedge-Sickle" Sign.
    Ultrasound Med Biol 2016 Oct 18;42(10):2357-66. Epub 2016 Jul 18.
    Department of Neurology, Städtisches Klinikum Dessau, Dessau-Rosslau, Germany.
    Thoracic outlet syndrome (TOS) is a disorder characterized by compression of the lower trunk of the brachial plexus, most often in association with anomalous congenital fibromuscular bands in the scalenic region. Early diagnosis is important, because the neurologic deficit associated with TOS may be irreversible. Using high-resolution ultrasound, we investigated 20 consecutive patients with clinical signs suggestive of TOS (all females, average age: 40. Read More

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