Thoracic Outlet Syndrome (TOS)

Advanced Diagnostics of Thoracic Outlet Syndrome (TOS)

Accurate diagnosis is essential for effectively treating Thoracic Outlet Syndrome (TOS), as its symptoms often overlap with other conditions. At Emirates Hospitals, advanced diagnostic techniques are employed to identify the specific type of TOS—whether neurogenic, venous, or arterial—and to develop a personalized treatment plan.

Clinical Examination

A thorough clinical examination is the first step in diagnosing TOS. Healthcare providers assess common symptoms like arm weakness, numbness, and swelling, along with physical signs such as muscle wasting or a positive Adson’s test, which helps identify nerve compression.

• Adson’s Test: A physical maneuver where the patient turns their head and takes a deep breath while the clinician checks the pulse, helping to diagnose nerve compression.
• Postural Evaluation: Assesses the patient’s posture to identify any abnormal positions that could be contributing to the compression of nerves or blood vessels.

Imaging Techniques

Imaging techniques are essential for confirming the diagnosis and assessing the severity of TOS. These tools help identify structural abnormalities and compression points.

• X-Rays: X-ray imaging can reveal structural issues such as cervical rib formation or misalignment of the first rib, which may cause TOS.
• CT Scans: Provide detailed cross-sectional images of bones, soft tissues, and blood vessels, which are critical for diagnosing venous or arterial compression.
• MRI Scans: MRI provides high-resolution images of soft tissues and is particularly useful for detecting nerve or vascular compression in neurogenic and arterial TOS.

Neurophysiological Studies

Neurophysiological tests are critical for evaluating the degree of nerve compression and function in neurogenic TOS.

• Nerve Conduction Studies (NCS): These studies measure the speed and strength of electrical signals in nerves, helping to detect nerve damage caused by compression.
• Electromyography (EMG): EMG assesses muscle electrical activity, identifying weakness or dysfunction caused by nerve compression in TOS.

Vascular Studies

For venous or arterial TOS, vascular studies are conducted to evaluate blood flow and detect any blockages or obstructions.

• Duplex Ultrasound: This non-invasive imaging technique assesses blood flow in the veins and arteries, identifying any clots or other vascular abnormalities.
• Angiography: In cases of suspected arterial or venous blockages, angiography uses contrast dye to visualize blood vessels, highlighting any areas of compression or obstruction.