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Thoracic outlet syndrome(TOS)

MedGen UID:
21158
•Concept ID:
C0039984
•
Disease or Syndrome
Synonym: TOS
SNOMED CT: Thoracic outlet syndrome (128210009); TOS - Thoracic outlet syndrome (128210009)
 
Monarch Initiative: MONDO:0005979
Orphanet: ORPHA97330

Definition

Thoracic outlet syndrome (TOS) is a group of disorders characterized by paresthesias, pain and weakness of the upper extremities due to compression, tension or inflammation of the neurovascular bundle as it passes through the thoracic outlet. There are 3 forms of TOS with different clinical pictures and etiologies: neurogenic TOS (NTOS) that can be divided into true or disputed forms, arterial TOS (ATOS) and venous TOS (VTOS) (see these terms). [from ORDO]

Term Hierarchy

CClinical test,  RResearch test,  OOMIM,  GGeneReviews,  VClinVar  
  • CROGVThoracic outlet syndrome
Follow this link to review classifications for Thoracic outlet syndrome in Orphanet.

Professional guidelines

PubMed

Thoracic outlet syndrome: a review for the primary care provider.
Cavanna AC, Giovanis A, Daley A, Feminella R, Chipman R, Onyeukwu V
J Osteopath Med 2022 Nov 1;122(11):587-599. Epub 2022 Aug 29 doi: 10.1515/jom-2021-0276. PMID: 36018621
Physical Therapy Management of Neurogenic Thoracic Outlet Syndrome.
Collins E, Orpin M
Thorac Surg Clin 2021 Feb;31(1):61-69. doi: 10.1016/j.thorsurg.2020.09.003. PMID: 33220772
Thoracic outlet syndrome: definition, aetiological factors, diagnosis, management and occupational impact.
Laulan J, Fouquet B, Rodaix C, Jauffret P, Roquelaure Y, Descatha A
J Occup Rehabil 2011 Sep;21(3):366-73. doi: 10.1007/s10926-010-9278-9. PMID: 21193950Free PMC Article

Recent clinical studies

Etiology

Neurogenic thoracic outlet syndrome: When to consider the diagnosis and current management options.
Kam Fai Ho K, Guazzo L, Muller J
Aust J Gen Pract 2023 Sep;52(9):627-632. doi: 10.31128/AJGP-09-22-6571. PMID: 37666785
Neurogenic Thoracic Outlet Syndrome.
Dengler NF, Pedro MT, Kretschmer T, Heinen C, Rosahl SK, Antoniadis G
Dtsch Arztebl Int 2022 Oct 28;119(43):735-742. doi: 10.3238/arztebl.m2022.0296. PMID: 35978467Free PMC Article
Thoracic outlet syndrome: a narrative review.
Masocatto NO, Da-Matta T, Prozzo TG, Couto WJ, Porfirio G
Rev Col Bras Cir 2019;46(5):e20192243. Epub 2019 Dec 20 doi: 10.1590/0100-6991e-20192243. PMID: 31859722
Reporting standards of the Society for Vascular Surgery for thoracic outlet syndrome.
Illig KA, Donahue D, Duncan A, Freischlag J, Gelabert H, Johansen K, Jordan S, Sanders R, Thompson R
J Vasc Surg 2016 Sep;64(3):e23-35. doi: 10.1016/j.jvs.2016.04.039. PMID: 27565607
Thoracic outlet syndrome: definition, aetiological factors, diagnosis, management and occupational impact.
Laulan J, Fouquet B, Rodaix C, Jauffret P, Roquelaure Y, Descatha A
J Occup Rehabil 2011 Sep;21(3):366-73. doi: 10.1007/s10926-010-9278-9. PMID: 21193950Free PMC Article

Diagnosis

Thoracic outlet syndrome: a review.
Panther EJ, Reintgen CD, Cueto RJ, Hao KA, Chim H, King JJ
J Shoulder Elbow Surg 2022 Nov;31(11):e545-e561. Epub 2022 Aug 10 doi: 10.1016/j.jse.2022.06.026. PMID: 35963513
Physical Therapy Management of Neurogenic Thoracic Outlet Syndrome.
Collins E, Orpin M
Thorac Surg Clin 2021 Feb;31(1):61-69. doi: 10.1016/j.thorsurg.2020.09.003. PMID: 33220772
Thoracic outlet syndrome: a narrative review.
Masocatto NO, Da-Matta T, Prozzo TG, Couto WJ, Porfirio G
Rev Col Bras Cir 2019;46(5):e20192243. Epub 2019 Dec 20 doi: 10.1590/0100-6991e-20192243. PMID: 31859722
Thoracic outlet syndrome.
Kuhn JE, Lebus V GF, Bible JE
J Am Acad Orthop Surg 2015 Apr;23(4):222-32. doi: 10.5435/JAAOS-D-13-00215. PMID: 25808686
Diagnosis of thoracic outlet syndrome.
Sanders RJ, Hammond SL, Rao NM
J Vasc Surg 2007 Sep;46(3):601-4. doi: 10.1016/j.jvs.2007.04.050. PMID: 17826254

Therapy

Neurogenic Thoracic Outlet Syndrome.
Dengler NF, Pedro MT, Kretschmer T, Heinen C, Rosahl SK, Antoniadis G
Dtsch Arztebl Int 2022 Oct 28;119(43):735-742. doi: 10.3238/arztebl.m2022.0296. PMID: 35978467Free PMC Article
Thoracic Outlet Syndrome Part I: Systematic Review of the Literature and Consensus on Anatomy, Diagnosis, and Classification of Thoracic Outlet Syndrome by the European Association of Neurosurgical Societies' Section of Peripheral Nerve Surgery.
Dengler NF, Ferraresi S, Rochkind S, Denisova N, Garozzo D, Heinen C, Alimehmeti R, Capone C, Barone DG, Zdunczyk A, Pedro MT, Antoniadis G, Kaiser R, Dubuisson A, Kretschmer T, Rasulic L
Neurosurgery 2022 Jun 1;90(6):653-667. Epub 2022 Mar 25 doi: 10.1227/neu.0000000000001908. PMID: 35319532Free PMC Article
Physical therapy management, surgical treatment, and patient-reported outcomes measures in a prospective observational cohort of patients with neurogenic thoracic outlet syndrome.
Balderman J, Abuirqeba AA, Eichaker L, Pate C, Earley JA, Bottros MM, Jayarajan SN, Thompson RW
J Vasc Surg 2019 Sep;70(3):832-841. Epub 2019 Mar 7 doi: 10.1016/j.jvs.2018.12.027. PMID: 30852035
Guidance for the treatment of deep vein thrombosis and pulmonary embolism.
Streiff MB, Agnelli G, Connors JM, Crowther M, Eichinger S, Lopes R, McBane RD, Moll S, Ansell J
J Thromb Thrombolysis 2016 Jan;41(1):32-67. doi: 10.1007/s11239-015-1317-0. PMID: 26780738Free PMC Article
Conservative treatment of thoracic outlet syndrome. A review of the literature.
Vanti C, Natalini L, Romeo A, Tosarelli D, Pillastrini P
Eura Medicophys 2007 Mar;43(1):55-70. Epub 2006 Sep 24 PMID: 16955064

Prognosis

Physical therapy management, surgical treatment, and patient-reported outcomes measures in a prospective observational cohort of patients with neurogenic thoracic outlet syndrome.
Balderman J, Abuirqeba AA, Eichaker L, Pate C, Earley JA, Bottros MM, Jayarajan SN, Thompson RW
J Vasc Surg 2019 Sep;70(3):832-841. Epub 2019 Mar 7 doi: 10.1016/j.jvs.2018.12.027. PMID: 30852035
Reporting standards of the Society for Vascular Surgery for thoracic outlet syndrome.
Illig KA, Donahue D, Duncan A, Freischlag J, Gelabert H, Johansen K, Jordan S, Sanders R, Thompson R
J Vasc Surg 2016 Sep;64(3):e23-35. doi: 10.1016/j.jvs.2016.04.039. PMID: 27565607
Guidance for the treatment of deep vein thrombosis and pulmonary embolism.
Streiff MB, Agnelli G, Connors JM, Crowther M, Eichinger S, Lopes R, McBane RD, Moll S, Ansell J
J Thromb Thrombolysis 2016 Jan;41(1):32-67. doi: 10.1007/s11239-015-1317-0. PMID: 26780738Free PMC Article
Thoracic outlet syndrome.
Kuhn JE, Lebus V GF, Bible JE
J Am Acad Orthop Surg 2015 Apr;23(4):222-32. doi: 10.5435/JAAOS-D-13-00215. PMID: 25808686
Thoracic outlet syndrome: definition, aetiological factors, diagnosis, management and occupational impact.
Laulan J, Fouquet B, Rodaix C, Jauffret P, Roquelaure Y, Descatha A
J Occup Rehabil 2011 Sep;21(3):366-73. doi: 10.1007/s10926-010-9278-9. PMID: 21193950Free PMC Article

Clinical prediction guides

Neurogenic Thoracic Outlet Syndrome.
Dengler NF, Pedro MT, Kretschmer T, Heinen C, Rosahl SK, Antoniadis G
Dtsch Arztebl Int 2022 Oct 28;119(43):735-742. doi: 10.3238/arztebl.m2022.0296. PMID: 35978467Free PMC Article
A review of upper extremity deep vein thrombosis.
Khan O, Marmaro A, Cohen DA
Postgrad Med 2021 Aug;133(sup1):3-10. Epub 2021 Mar 8 doi: 10.1080/00325481.2021.1892390. PMID: 33618595
Reporting standards of the Society for Vascular Surgery for thoracic outlet syndrome.
Illig KA, Donahue D, Duncan A, Freischlag J, Gelabert H, Johansen K, Jordan S, Sanders R, Thompson R
J Vasc Surg 2016 Sep;64(3):e23-35. doi: 10.1016/j.jvs.2016.04.039. PMID: 27565607
Guidance for the treatment of deep vein thrombosis and pulmonary embolism.
Streiff MB, Agnelli G, Connors JM, Crowther M, Eichinger S, Lopes R, McBane RD, Moll S, Ansell J
J Thromb Thrombolysis 2016 Jan;41(1):32-67. doi: 10.1007/s11239-015-1317-0. PMID: 26780738Free PMC Article
Thoracic outlet syndrome.
Kuhn JE, Lebus V GF, Bible JE
J Am Acad Orthop Surg 2015 Apr;23(4):222-32. doi: 10.5435/JAAOS-D-13-00215. PMID: 25808686

Recent systematic reviews

Thoracic outlet syndrome in females: A systematic review.
Cralle LE, Harris LM, Lum YW, Deery SE, Humphries MD
Semin Vasc Surg 2023 Dec;36(4):487-491. Epub 2023 Sep 23 doi: 10.1053/j.semvascsurg.2023.09.003. PMID: 38030322
Management of Paget-Schroetter Syndrome: a Systematic Review and Meta-Analysis.
Hoexum F, Hoebink M, Coveliers HME, Wisselink W, Jongkind V, Yeung KK
Eur J Vasc Endovasc Surg 2023 Dec;66(6):866-875. Epub 2023 Sep 6 doi: 10.1016/j.ejvs.2023.08.065. PMID: 37678659
Thoracic Outlet Syndrome Part I: Systematic Review of the Literature and Consensus on Anatomy, Diagnosis, and Classification of Thoracic Outlet Syndrome by the European Association of Neurosurgical Societies' Section of Peripheral Nerve Surgery.
Dengler NF, Ferraresi S, Rochkind S, Denisova N, Garozzo D, Heinen C, Alimehmeti R, Capone C, Barone DG, Zdunczyk A, Pedro MT, Antoniadis G, Kaiser R, Dubuisson A, Kretschmer T, Rasulic L
Neurosurgery 2022 Jun 1;90(6):653-667. Epub 2022 Mar 25 doi: 10.1227/neu.0000000000001908. PMID: 35319532Free PMC Article
Thoracic outlet syndrome: wide literature for few cases. Status of the art.
Doneddu PE, Coraci D, De Franco P, Paolasso I, Caliandro P, Padua L
Neurol Sci 2017 Mar;38(3):383-388. Epub 2016 Dec 16 doi: 10.1007/s10072-016-2794-4. PMID: 27987052
Outcome of Surgical Treatment for Thoracic Outlet Syndrome: Systematic Review and Meta-Analysis.
Peek J, Vos CG, Ünlü Ç, van de Pavoordt HDWM, van den Akker PJ, de Vries JPM
Ann Vasc Surg 2017 Apr;40:303-326. Epub 2016 Sep 22 doi: 10.1016/j.avsg.2016.07.065. PMID: 27666803

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