Local compression by these structures affects the brachial plexus and subclavian vessels. The structures involved in TOS are the first rib, scalene muscles, and clavicle. Thoracic outlet syndrome (TOS) is a group of disorders involving compression of the nerves and/or blood vessels in the thoracic outlet region ( i.e., the lower neck and upper chest areas). Clinicians who encounter patients with TOS need to understand its key features to avoid misdiagnosis and provide appropriate treatment. Neuromuscular physicians tend to be skeptical about the existence of disputed TOS, but thoracic surgeons argue that disputed TOS is under-diagnosed. The existence of a disputed TOS remains controversial. Electrodiagnostic and imaging studies are helpful for excluding other possible disorders and confirming the diagnosis of true neurogenic TOS. Since identifying the causative lesions is complex, detailed history taking and thorough clinical investigation are needed. ![]() Both true neurogenic and disputed TOS are considered neurogenic TOS. TOS is usually classified into three types, neurogenic, venous, and arterial, according to the primarily affected structure. We reviewed the pathophysiology, clinical evaluation, differential dia gnoses, and treatment of TOS. ![]() TOS results in pain, numbness, paresthesia, and motor weakness in the affected upper limb. Thoracic outlet syndrome (TOS) is a group of diverse disorders involving compression of the nerves and/or blood vessels in the thoracic outlet region.
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