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Thoracic outlet syndrome

An evidence-led atlas separating neurogenic, venous, and arterial subtypes, differential diagnosis, and subtype-specific conservative or surgical care.

thoracic outlet syndrome · TOS

MONDO:0005979Public QA completeSource-bound · 4

Disease at a glance

Start with the essentials, then explore the patient and research views.

Public revision · a883bcc437a5

Disease class
Thoracic outlet syndrome is a group of disorders caused by compression of nerves or vessels below the neck.
Core mechanism
Compression of the brachial plexus, subclavian vein, or subclavian artery defines neurogenic, venous, and arterial subtypes.
Genes or cause
Anatomic variation, trauma, posture, and repetitive overhead activity can contribute.
Typical features
Neurogenic disease can cause neck or arm pain, numbness, paresthesia, and hand weakness.
Variability
Venous disease can cause arm swelling, cyanosis, and thrombosis; arterial disease can cause ischemia, color change, and embolization.
Diagnosis
No single test confirms every subtype; diagnosis integrates history, examination, subtype-specific testing, and exclusion of alternatives.
Management
Neurogenic diagnosis considers local symptoms, distal neurologic symptoms, absence of a better diagnosis, and response to a scalene test injection.
Treatment and research
Suspected vascular disease is evaluated with duplex ultrasound, CTA, MRA, or other imaging for compression, thrombosis, and vessel injury.
Reading evidence
Neurogenic disease is generally managed first with specialized physical therapy and activity or posture modification.
Key caution
Decompression surgery is considered in selected patients with persistent severe neurogenic symptoms or vascular injury.

For patients and families

A structured guide for understanding the disease and preparing for clinical conversations.

At a glance

Thoracic outlet syndrome is a group of disorders caused by compression of nerves or vessels below the neck.

Neurogenic disease can cause neck or arm pain, numbness, paresthesia, and hand weakness.

How the disease works

Compression of the brachial plexus, subclavian vein, or subclavian artery defines neurogenic, venous, and arterial subtypes.

Anatomic variation, trauma, posture, and repetitive overhead activity can contribute.

Why experiences vary

Venous disease can cause arm swelling, cyanosis, and thrombosis; arterial disease can cause ischemia, color change, and embolization.

Diagnosis and management

No single test confirms every subtype; diagnosis integrates history, examination, subtype-specific testing, and exclusion of alternatives.

Treatment status

Neurogenic diagnosis considers local symptoms, distal neurologic symptoms, absence of a better diagnosis, and response to a scalene test injection.

Suspected vascular disease is evaluated with duplex ultrasound, CTA, MRA, or other imaging for compression, thrombosis, and vessel injury.

Reading clinical trials

Follow-up monitors treatment response, recurrence, and neurologic and vascular function.

Topics for a clinical visit

Clinical discussion should address subtype, thrombotic or ischemic urgency, alternative diagnoses, test scope, and risks of conservative or surgical care.

Medical notice

This material is for disease education and is not a personal diagnosis or treatment instruction.

Evidence and sources

A trial registry status does not establish efficacy or regulatory approval.