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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

Neurogenic Thoracic Outlet Syndrome in Athletes - Nonsurgical Treatment Options.
Warrick A, Davis B
Curr Sports Med Rep 2021 Jun 1;20(6):319-326. doi: 10.1249/JSR.0000000000000854. PMID: 34099610
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
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

Recent clinical studies

Etiology

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
Neurogenic Thoracic Outlet Syndrome in Athletes - Nonsurgical Treatment Options.
Warrick A, Davis B
Curr Sports Med Rep 2021 Jun 1;20(6):319-326. doi: 10.1249/JSR.0000000000000854. PMID: 34099610
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
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
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

Neurogenic Thoracic Outlet Syndrome in Athletes - Nonsurgical Treatment Options.
Warrick A, Davis B
Curr Sports Med Rep 2021 Jun 1;20(6):319-326. doi: 10.1249/JSR.0000000000000854. PMID: 34099610
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
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

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
Neurogenic Thoracic Outlet Syndrome in Athletes - Nonsurgical Treatment Options.
Warrick A, Davis B
Curr Sports Med Rep 2021 Jun 1;20(6):319-326. doi: 10.1249/JSR.0000000000000854. PMID: 34099610
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
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

How Common Is Thoracic Outlet Syndrome?
Illig KA, Rodriguez-Zoppi E
Thorac Surg Clin 2021 Feb;31(1):11-17. doi: 10.1016/j.thorsurg.2020.09.001. PMID: 33220767
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
Treatment for thoracic outlet syndrome.
Povlsen B, Hansson T, Povlsen SD
Cochrane Database Syst Rev 2014 Nov 26;(11):CD007218. doi: 10.1002/14651858.CD007218.pub3. PMID: 25427003
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
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
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 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
A systematic review of musculoskeletal complaints, symptoms, and pathologies related to mobile phone usage.
Zirek E, Mustafaoglu R, Yasaci Z, Griffiths MD
Musculoskelet Sci Pract 2020 Oct;49:102196. Epub 2020 May 27 doi: 10.1016/j.msksp.2020.102196. PMID: 32861360
Thoracic dysfunction in whiplash associated disorders: A systematic review.
Heneghan NR, Smith R, Tyros I, Falla D, Rushton A
PLoS One 2018;13(3):e0194235. Epub 2018 Mar 23 doi: 10.1371/journal.pone.0194235. PMID: 29570722Free PMC Article
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
Treatment for thoracic outlet syndrome.
Povlsen B, Hansson T, Povlsen SD
Cochrane Database Syst Rev 2014 Nov 26;(11):CD007218. doi: 10.1002/14651858.CD007218.pub3. PMID: 25427003

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