THORACIC
OUTLET SYNDROMES
BY. DR. STEVEN L. KLEINFIELD D.A.B.C.O.
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DEFINITION
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Thoracic outlet syndromes represent many different conditions that have
one main thing in common: Compression of the neruovascular bundle with
resultant peripheral symptomology.
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CLASSIFICATION OF THORACIC OUTLET
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COSTOCLAVICULAR
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POSTURAL COMPRESSION
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PECTORAL COMPRESION
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HYPERABDUCTION SYNDROME
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SLEEP DYSESTHESIA
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CERVICAL RIB COMPRESSION
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SCALENE ANTICUS
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HISTORY IN T.O.S. CASES
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O.P.Q.R.S.T. APPROACH
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ONSET: ASK IF THE SYMPTOMS ARE ACUTE IN ONSET OR
LONG STANDING MAY HELP TO DETERMINE OUTCOME.
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PAIN & PROVICATION: ASK ABOUT THE LOCATION OF THE
PAIN, GET PATIENT TO FILL OUT A PAIN DIAGRAM. FIND OUT WHAT
MAKES THE COMPLAINT BETTER OR WORSE.
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QUALITY: IS IT A NUMBNESS, TINGLING, OR DOES THE LIMB
FEEL COLD. THIS WILL HELP DIFFERENTIATE NERVE FROM VASCULAR
HISTORY IN T.O.S. CASES COT...
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RADIATION: ASK IF THE PAIN SEEMS TO TRAVEL.
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SITE AND SEVERITY: ASK THE PATIENT TO MAP OUT THEIR
PAIN AND TO RATE IT ON A SCALE OF 1-10.
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TIME: FIND OUT WHEN THE PAIN IS WORSE AND WHEN THE PAIN FEELS
BETTER.. THIS MAY BE A JOB RELATED PROBLEM OR ONE FROM
SLEEPING POSTURE.
COSTOCLAVICULAR COMPRESSION SYNDROME:
DEFINITION:
FACTS/CLINICAL PEARLS:
SIGNS:
ORTHOPEDIC TESTING:
RADIOGRAPHS:
TREATMENT:
POSTURAL COMPRESSION SYNDROME
DEFINITION:
FACTS/CLINICAL PEARLS:
SIGNS:
ORTHOPEDIC TESTING:
RADIOGRAPHS:
TREATMENT:
PECTORAL COMPRESSION SYNDROME
DEFINITION:
FACTS/CLINICAL PEARLS:
SIGNS:
ORTHOPEDIC TESTING:
RADIOGRAPHS:
TREATMENT:
HYPERABDUCTION
SYNDROME
DEFINITION:
FACTS/CLINICAL PEARLS:
SIGNS:
ORTHOPEDIC TESTING:
RADIOGRAPHS:
TREATMENT:
SLEEP DYSESTHESIA
DEFINITION:
FACTS/CLINICAL PEARLS:
SIGNS:
ORTHOPEDIC TESTING:
RADIOGRAPHS:
TREATMENT:
CERVICAL RIB COMPRESSION
DEFINITION:
FACTS/CLINICAL PEARLS:
SIGNS:
ORTHOPEDIC TESTING:
RADIOGRAPHS:
TREATMENT:
ANTERIOR SCALENE SYNDROME
DEFINITION:
FACTS/CLINICAL PEARLS:
SIGNS:
ORTHOPEDIC TESTING:
RADIOGRAPHS:
TREATMENT: