CASE 3001 Published on 19.07.2005

A rare location of arterial compression in thoracic outlet syndrome (TOS)

Section

Cardiovascular

Case Type

Clinical Cases

Authors

Nishida T, Saito T, Sawada S, Mori Y

Patient

28 years, female

Clinical History
A 28-year-old female patient was admitted to the hospital because she had numbness and pain in her left arm.
Imaging Findings
A 28-year-old female patient was admitted to the hospital because she had numbness and pain in her left arm. A chest Xp revealed no abnormal findings. A clinical examination of the Adson test was found to be positive. An angiography was performed on the patient.
Discussion
On doing a surgery, it was found that the subclavian artery (axillary artery) and the brachial plexus were compressed by a fibrotic band near the pectoralis major tendon. The thoracic outlet syndrome (TOS) is known to be caused by the compression of the brachial plexus elements and/or subclavian vessels in their passage from the cervical area towards the axilla. Adson's test and Allen's test are clinical tests for detecting TOS. However, these tests may give positive findings in many asymptomatic patients. Arteriography and MRA have been included in the clinical examination to provide unbiased objective data. Mostly, compression of the vessels are demonstrated in the interscalenic triangle, the costclavicular space, the subcoracoid space and the space beneath the pectoralis minor tendon. This is a rare case with a vascular compression by the fibrotic band of the pectoralis major tendon.
Differential Diagnosis List
Thoracic outlet syndrome (TOS).
Final Diagnosis
Thoracic outlet syndrome (TOS).
Case information
URL: https://www.eurorad.org/case/3001
DOI: 10.1594/EURORAD/CASE.3001
ISSN: 1563-4086