Thoracic Outlet Syndrome

Doctors know thoracic outlet syndrome as TOS. Specifically, the thoracic outlet is the hollow space above your collarbone, between your shoulder and your neck. If you want to find your thoracic outlet, place your fingers on the side of your neck and slide down to the space above your collarbone.

Thoracic outlet syndrome-Brachial plexus, subclavian artery, and subclavian vein pass through the thoracic outlet.

Many anatomic variations appear in the thoracic outlet that can cause narrowing of this important space, often made worse with arm motion. This narrowing compresses the vessels or nerves, causing blood clots, pain, tingling, numbness, weakness or muscle wasting. Clinical diagnosis of TOS is limited, but MRI proves anatomic abnormalities, compression, and blood clots.


What is TOS?
Formation or migration of a blood clot causes the sudden onset of pain, swelling, or weakness in patients with arterial TOS or venous TOS. As a result, doctors focus on imaging tests to find these blood clots. Once a blood clot is confirmed, doctors use further imaging tests to administer clot-dissolving drugs, and to evaluate the progress of treatment.

Mature silver-haired doctor with stethoscope diagnosing TOS

Doctors see many patients with neck and arm pain, numbness and tingling. Unfortunately, physical examination tests for neurogenic TOS have major limitations. In contrast, modern imaging tests clearly show anatomic variations, arm motion, and compression of the brachial plexus, helping to prove the diagnosis of neurogenic TOS.


Diagnosis of TOS
Doctors treat venous TOS by urgently removing the venous blood clot that caused the syndrome. Later, doctors must repair any damaged vein segment and the structures that compress the vein.

Young woman doctor in blue scrubs with clipboard and stethoscope

Doctors treat arterial TOS with emergency surgery to remove blood clots that block blood flow to the arm. Later, doctors must repair any damaged arterial segment and remove any structures that compress the artery.

Treatment of neurogenic TOS requires removal of abnormal soft tissues or a segment of first rib, depending on the structures that compress the brachial plexus.


Treatment of TOS

Thoracic Outlet Syndrome

What is Thoracic Outlet Syndrome?

Thoracic outlet syndrome, TOS, causes neck and arm pain, numbness and tingling.

Three forms of TOS exist, resulting from compression of a large vein, a large artery, or a large network of nerves in the side of the neck. Compression can cause blood clots, pain, numbness, tingling, and eventually weakness or muscle wasting. TOS causes serious disease, but it is hard to diagnose and treat.

Doctors know thoracic outlet syndrome as TOS. Specifically, the thoracic outlet is the hollow space above your collarbone, between your shoulder and your neck. If you want to find your thoracic outlet, place your fingers on the side of your neck and slide down to the space above your collarbone.

Thoracic outlet syndrome-Brachial plexus, subclavian artery, and subclavian vein pass through the thoracic outlet.

Many anatomic variations appear in the thoracic outlet that can cause narrowing of this important space, often made worse with arm motion. This narrowing compresses the vessels or nerves, causing blood clots, pain, tingling, numbness, weakness or muscle wasting. Clinical diagnosis of TOS is limited, but MRI proves anatomic abnormalities, compression, and blood clots.


What is TOS?

Diagnosis of Thoracic Outlet Syndrome

The accurate and timely diagnosis of thoracic outlet syndrome makes a critical difference in treatment outcomes.

It is important for doctors to diagnose patients with arterial TOS or venous TOS promptly. Ultrasound, angiogram, CT or MRI can find critical blood clots.

Unfortunately, the clinical examination of neurogenic TOS has limited value. In that case, doctors should consider using modern imaging tests like MRI to confirm their clinical diagnosis. MRI provides valuable information in TOS patients.

Formation or migration of a blood clot causes the sudden onset of pain, swelling, or weakness in patients with arterial TOS or venous TOS. As a result, doctors focus on imaging tests to find these blood clots. Once a blood clot is confirmed, doctors use further imaging tests to administer clot-dissolving drugs, and to evaluate the progress of treatment.

Mature silver-haired doctor with stethoscope diagnosing TOS

Doctors see many patients with neck and arm pain, numbness and tingling. Unfortunately, physical examination tests for neurogenic TOS have major limitations. In contrast, modern imaging tests clearly show anatomic variations, arm motion, and compression of the brachial plexus, helping to prove the diagnosis of neurogenic TOS.


Diagnosis of TOS

Treatment of Thoracic Outlet Syndrome

Thoracic outlet syndrome can be successfully treated, especially if it is diagnosed quickly and accurately.

In general, doctors treat patients with arterial and venous TOS urgently, using surgical treatments.

On the other hand, doctors frequently treat patients with neurogenic TOS with conservative methods, before considering surgery.

Doctors treat venous TOS by urgently removing the venous blood clot that caused the syndrome. Later, doctors must repair any damaged vein segment and the structures that compress the vein.

Young woman doctor in blue scrubs with clipboard and stethoscope

Doctors treat arterial TOS with emergency surgery to remove blood clots that block blood flow to the arm. Later, doctors must repair any damaged arterial segment and remove any structures that compress the artery.

Treatment of neurogenic TOS requires removal of abnormal soft tissues or a segment of first rib, depending on the structures that compress the brachial plexus.


Treatment of TOS
We can help. Ask us a question about thoracic outlet syndrome. Find a NeoVista® imaging partner near you. Connect with a TOS specialist. Get a consultation for your TOS. Make an appointment with the NeoVista® TOS Multi-Specialty Group. Or share a TOS news article or TOS resource to help other TOS patients.


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At present, no gold standard exists for the diagnosis of neurogenic TOS. Doctors use many clinical tests that have poor accuracy. Even if a doctor diagnoses TOS accurately, the exact cause remains unknown in any patient.

Fortunately, modern imaging tests show the causes of each type of TOS in great detail. 

We have spent a lot of time and effort learning about the diagnosis of TOS. We feel that our unique MRI examination improves the diagnosis of patients with thoracic outlet syndrome. NeoVista® examinations are performed throughout the country. Our imaging partners share our passion to improve the diagnosis and treatment of thoracic outlet syndrome.


About NeoVista®

We hear lots of TOS patient stories. And we feel for each patient. We know its hard to recover from TOS. And we know the system doesn’t always help.

That’s why we made this website. Throughout our site, we provide education, answers, and inspiration for all TOS patients. We can help TOS patients meet each other, and find TOS providers.

You can learn the anatomy of the thoracic outlet, and what causes TOS. Also, you can learn how doctors diagnose TOS, and what tests they can order to prove the causes of TOS. Understand these tests, and how they can help you. Find TOS specialists around the country. Find other resources around the web to learn other opinions and treatments. And you can ask us for help directly with your case.


TOS Education