How do patients with thoracic outlet syndrome (TOS) present?
The clinical presentation is secondary to compression of the subclavian artery, subclavian vein, and/or brachial plexus as these structures traverse the thoracic outlet. Patients may present with symptoms and signs of upper extremity tingling, weakness, swelling, heaviness, numbness, or hand claudication, which are typically reproduced or exacerbated by elevation or sustained use of the upper extremities. Young women are most commonly affected.
Major causes of TOS include osseous abnormalities (including a cervical rib, or excess callus, exostosis, or tumor of the first rib or clavicle) as well as soft tissue abnormalities (including a fibrous band, congenital and acquired muscle abnormalities, and soft tissue scarring).
