Diagnosis of thoracic outlet syndrome remains a challenge to many doctors. Clinical tests have tried and failed. You have likely heard of Adson’s test or the Wright test. However, these clinical tests fail to achieve good accuracy. Diagnostic lab tests, including EMG/NCV, do not provide reliable results. Fortunately, modern imaging tests can be tailored to diagnose TOS.
As a result, we now have improved understanding of the anatomy and causes of TOS. It is important to keep in mind that different diagnostic tests have advantages and disadvantages. In particular, MRI shows all of the vital structures of the thoracic outlet, as well as pathology. CT is fast, but requires radiation. Additionally, CT does not show all soft tissue structures. MRI requires no radiation. Notably, MRI shows all important soft tissues. MRI can isolate blood vessels and nerves. Finally, MRI can create images in multiple arm positions. Experienced TOS specialists around the country are learning how the NeoVista® MRI can help diagnose TOS.