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Thoracic Outlet Syndrome

Storm ESS - MedPix (2005)

View Article: MedPix Image - MedPix Case

Affiliation: Uniformed Services University

ABSTRACT

Diagnosis: Thoracic Outlet Syndrome

History: Patient had several matted left supraclavicular nodes resected approximately 10 years ago. She now presents with progressive heaviness and pallor of the left arm, which is exaccerbated by abduction and external rotation at the shoulder. No other significant medical history. No current medications.

Findings: There is dynamic compression of the left subclavian artery between the left first rib and clavicle, with some post-stenotic dilitation present. Blood flow velocity to the distal left upper extremity is diminished with arm abduction. Notible lack of venous flow, even on delayed sequences.

Ddx: Thoracic Outlet Syndrome Reflex Symphathetic Dystrophy

Dxhow: Conventional Angiography, with dynamic arm maneuvering.

Exam: Diminished left radial pulse with full shoulder abduction. Normal heme/coag profile.

No MeSH data available.


Conventional left subclavian arteriogram demonstrating compression of the artery between the clavicle and first rib, with associated post-stenotic dilitation (small arrow, top left image).  Also note that the compression is most evident when the arm is in full abduction and external rotation (bottom right image), which resulted in patient reporting symptoms.  There is a notable lack of venous enhancement, even on delayed images.
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MPX1392_synpic18451: Conventional left subclavian arteriogram demonstrating compression of the artery between the clavicle and first rib, with associated post-stenotic dilitation (small arrow, top left image). Also note that the compression is most evident when the arm is in full abduction and external rotation (bottom right image), which resulted in patient reporting symptoms. There is a notable lack of venous enhancement, even on delayed images.


Thoracic Outlet Syndrome

Storm ESS - MedPix (2005)

Conventional left subclavian arteriogram demonstrating compression of the artery between the clavicle and first rib, with associated post-stenotic dilitation (small arrow, top left image).  Also note that the compression is most evident when the arm is in full abduction and external rotation (bottom right image), which resulted in patient reporting symptoms.  There is a notable lack of venous enhancement, even on delayed images.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=MPX1392&req=5

MPX1392_synpic18451: Conventional left subclavian arteriogram demonstrating compression of the artery between the clavicle and first rib, with associated post-stenotic dilitation (small arrow, top left image). Also note that the compression is most evident when the arm is in full abduction and external rotation (bottom right image), which resulted in patient reporting symptoms. There is a notable lack of venous enhancement, even on delayed images.

View Article: MedPix Image - MedPix Case

Affiliation: Uniformed Services University

ABSTRACT

Diagnosis: Thoracic Outlet Syndrome

History: Patient had several matted left supraclavicular nodes resected approximately 10 years ago. She now presents with progressive heaviness and pallor of the left arm, which is exaccerbated by abduction and external rotation at the shoulder. No other significant medical history. No current medications.

Findings: There is dynamic compression of the left subclavian artery between the left first rib and clavicle, with some post-stenotic dilitation present. Blood flow velocity to the distal left upper extremity is diminished with arm abduction. Notible lack of venous flow, even on delayed sequences.

Ddx: Thoracic Outlet Syndrome Reflex Symphathetic Dystrophy

Dxhow: Conventional Angiography, with dynamic arm maneuvering.

Exam: Diminished left radial pulse with full shoulder abduction. Normal heme/coag profile.

No MeSH data available.