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Neurogenic thoracic outlet syndrome: A case report and review of the literature.

Boezaart AP, Haller A, Laduzenski S, Koyyalamudi VB, Ihnatsenka B, Wright T - Int J Shoulder Surg (2010)

Bottom Line: She first received repeated conservative treatments with 60 units of botulinium toxin injected into the anterior scalene muscle at three-month intervals, which providing excellent results of symptom-free periods.Patients with NTOS often get operated upon - even if just a diagnostic arthroscopy, and an interscalene or other brachial plexus block may be performed.This might put the patient in jeopardy of permanent nerve injury, and the purpose of this review is to minimize or prevent this.

View Article: PubMed Central - PubMed

Affiliation: Department of Anesthesiology, Division of Acute Pain Medicine and Regional Anesthesia, University of Florida, College of Medicine, Gainesville, Florida, United States of American Society of Anesthesiologists.

ABSTRACT
Neurogenic thoracic outlet syndrome (NTOS) is an oft-overlooked and obscure cause of shoulder pain, which regularly presents to the office of shoulder surgeons and pain specialist. With this paper we present an otherwise healthy young female patient with typical NTOS. She first received repeated conservative treatments with 60 units of botulinium toxin injected into the anterior scalene muscle at three-month intervals, which providing excellent results of symptom-free periods. Later a trans-axillary first rib resection provided semi-permanent relief. The patient was followed for 10 years after which time the symptoms reappeared. We review the literature and elaborate on the anatomy, sonoanatomy, etiology and characteristics, symptoms, diagnostic criteria and treatment modalities of NTOS. Patients with NTOS often get operated upon - even if just a diagnostic arthroscopy, and an interscalene or other brachial plexus block may be performed. This might put the patient in jeopardy of permanent nerve injury, and the purpose of this review is to minimize or prevent this.

No MeSH data available.


Related in: MedlinePlus

Infraclavicular probe position (position 3 in Figure 2)
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Related In: Results  -  Collection

License
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Figure 0005: Infraclavicular probe position (position 3 in Figure 2)

Mentions: Holding the ultrasound probe in positions 1, 2, and 3 as depicted in Figure 2, the sono-anatomy can be demonstrated as shown in Figure 3 (probe position 1), Figure 4 (probe position 2), and Figure 5 (probe position 3).


Neurogenic thoracic outlet syndrome: A case report and review of the literature.

Boezaart AP, Haller A, Laduzenski S, Koyyalamudi VB, Ihnatsenka B, Wright T - Int J Shoulder Surg (2010)

Infraclavicular probe position (position 3 in Figure 2)
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2966747&req=5

Figure 0005: Infraclavicular probe position (position 3 in Figure 2)
Mentions: Holding the ultrasound probe in positions 1, 2, and 3 as depicted in Figure 2, the sono-anatomy can be demonstrated as shown in Figure 3 (probe position 1), Figure 4 (probe position 2), and Figure 5 (probe position 3).

Bottom Line: She first received repeated conservative treatments with 60 units of botulinium toxin injected into the anterior scalene muscle at three-month intervals, which providing excellent results of symptom-free periods.Patients with NTOS often get operated upon - even if just a diagnostic arthroscopy, and an interscalene or other brachial plexus block may be performed.This might put the patient in jeopardy of permanent nerve injury, and the purpose of this review is to minimize or prevent this.

View Article: PubMed Central - PubMed

Affiliation: Department of Anesthesiology, Division of Acute Pain Medicine and Regional Anesthesia, University of Florida, College of Medicine, Gainesville, Florida, United States of American Society of Anesthesiologists.

ABSTRACT
Neurogenic thoracic outlet syndrome (NTOS) is an oft-overlooked and obscure cause of shoulder pain, which regularly presents to the office of shoulder surgeons and pain specialist. With this paper we present an otherwise healthy young female patient with typical NTOS. She first received repeated conservative treatments with 60 units of botulinium toxin injected into the anterior scalene muscle at three-month intervals, which providing excellent results of symptom-free periods. Later a trans-axillary first rib resection provided semi-permanent relief. The patient was followed for 10 years after which time the symptoms reappeared. We review the literature and elaborate on the anatomy, sonoanatomy, etiology and characteristics, symptoms, diagnostic criteria and treatment modalities of NTOS. Patients with NTOS often get operated upon - even if just a diagnostic arthroscopy, and an interscalene or other brachial plexus block may be performed. This might put the patient in jeopardy of permanent nerve injury, and the purpose of this review is to minimize or prevent this.

No MeSH data available.


Related in: MedlinePlus