Introduction

  • Why do you need an imaging test for thoracic outlet syndrome (TOS) to assess soft tissues and rule out differential diagnoses like spinal cord issues? Curious about how this diagnostic tool can provide crucial insights into your health? Imaging tests play a vital role in identifying TOS, guiding treatment decisions, and ensuring accurate diagnosis of soft tissues for doctors and differential diagnoses.

Table of Contents

Table of Contents

Steven Strasburg, star pitcher for the Washington Nationals and MVP of the 2019 World Series, pitched last night for the first time since July of 2021. Thus begins his comeback from thoracic outlet syndrome.

Strasburg was drafted by the Washington Nationals with the first overall pick in the 2009 MLB draft, and began his career in the major leagues for the first time in 2010. Besides winning the World Series MVP in 2019, Strasburg has been selected to the All-Star team 3 times. The hard-throwing righty averaged almost 95 miles per hour on his fastball in 2014. Strasburg struck out 23 batters in one college game, and threw a no-hitter with 17 strikeouts in another.

Steven Strasburg pitches during comeback from thoracic outlet syndrome

Since winning the World Series MVP in 2019, Strasburg has pitched only 26 2/3 innings. He underwent carpal tunnel surgery in 2020, and TOS surgery in July of 2021. Strasburg began his comeback from thoracic outlet syndrome in an inauspicious manner, giving up 7 runs to the Miami Marlins in 4 2/3 innings. After the game, Strasburg commented, “It felt good, and I’m excited to learn from it and get back out there for the next one. Fastball command could have been better in certain spots there. I felt the changeup was working pretty well. All in all, it’s a place to start and try to build off of it.”

How difficult is it for an elite MLB pitcher to comeback from thoracic outlet syndrome?

History has taught us that the odds of a MLB pitcher returning to his prior form are low. One example of an attempted comeback from thoracic outlet syndrome is that of former All-Star starting pitcher Matt Harvey:

Harvey’s career was derailed during the 2016 season when he started dealing with thoracic outlet syndrome that resulted in surgery. After beginning his career posting a 2.53 ERA and 1.00 WHIP over his first three seasons with the Mets from 2012 to 2015 (he missed the 2014 season due to Tommy John surgery), Harvey has posted a 5.92 ERA and 1.51 WHIP over the last six seasons.

Hopefully, Strasburg will overcome the challenges of his comeback from thoracic outlet syndrome, and enjoy a fruitful and successful year.


We have a short but pertinent update as of Thursday, June 13: Steven Strasburg experienced shoulder discomfort after his first start in almost a year. The team sent Strasburg for an MRI, and the Nationals are awaiting the results of this MRI. In the meantime, Strasburg has been placed on the 15-day injured list.


We thought the latest update on Steven Strasburg’s comeback from thoracic outlet syndrome is interesting and newsworthy.

Stephen Strasburg’s latest trip to the injured list will include a trip to see a specialist with no firm timetable for a return after the right-hander suffered a stress reaction in his second and third ribs, Nationals manager Davey Martinez announced Tuesday.

I have not seen stress reactions in the ribs adjacent to the surgical bed in the patients I have personally imaged. Additionally, I am not aware of any publications demonstrating this finding. This is an interesting development.

There are so many unknowns about this surgery and what can happen and this is part of it,” Martinez said in his pregame press conference. “It is related. We’re at a point now where, honestly, Stephen’s put all the work in. He’s done everything that he needed to do and it’s just the surgery, you don’t know where it’s going to go…There’s no timeline right now for Stephen. He’s gonna go see another specialist and then we’ll know more.

Actually, there is a good amount of medical literature on surgical outcomes, from many authors in many countries. However, there is a shockingly limited availability of literature on imaging in post-operative patients. In this day and age, where we use CT scans and MRI scans for almost every patient, we could sure use more of these amazing modern tools. That’s why we do what we do at Vanguard Specialty Imaging.

This case involves an elite, high-profile athlete, and some very interesting twists and turns. We remain optimistic for Steven’s comeback from thoracic outlet syndrome.

Stay tuned for more news as it develops.

Read more about thoracic outlet syndrome in athletes.

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