Arterial TOS and venous TOS patients usually present in dramatic fashion. Clinical examination and diagnostic tests in these patients are typically straightforward. However, these two types of TOS are rare.
Patients develop neurogenic TOS much more commonly. And, unfortunately, the diagnosis of neurogenic TOS is much more challenging than the diagnosis of arterial or venous TOS. Once your doctor suspects you have neurogenic TOS, he or she may perform a specialized physical examination. But these tests are known to be poorly accurate.
Modern imaging tests provide an amazing amount of detailed data showing the anatomy of the thoracic outlet. And in patients with neurogenic TOS, good imaging studies show exactly what is compression the nerves, arteries and veins. This information allows better treatment decisions, including whether to go to surgery, and what type of surgery is best.