A Case of Venous Thoracic Outlet Syndrome: Primary Care Review of Physical Exam Provocative Tests and Osteopathic Manipulative Technique Considerations
Eric Yuschak, Furqan Haq, Stacy Chase, Eric Yuschak, Furqan Haq, Stacy Chase
Abstract
Thoracic outlet syndrome (TOS) is a condition that results from the compression of the neurovascular bundle of the upper extremities. It has generally been divided into neurogenic and vascular TOS with vascular further being divided into venous and arterial. This case report is of a healthy 24-year-old female who was misdiagnosed initially in an emergency department only to return two days later for reevaluation. Here, the patient's admission and workup are discussed after she presented to the family medicine clinic for a referral for further evaluation by a cardiothoracic surgeon. Physical exam provocative tests which are often overlooked are reviewed, and osteopathic manipulative techniques and principles are mentioned.
Keywords: osteopathic manipulative treatment; physical exam skills; thoracic outlet syndrome.
Conflict of interest statement
The authors have declared that no competing interests exist.
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References
- Imaging of the patient with thoracic outlet syndrome. [Aug;2019 ];Raptis CA, Sridhar S, Thompson RW, Fowler KJ, Bhalla S. Radiographics. 2016 36:984–1000.
- Thoracic outlet syndrome. [May;2019 ]; 2015
- Paget-schroetter syndrome: review of pathogenesis and treatment of effort thrombosis. Alla VM, Natarajan N, Kaushik M, Warrier M, Nair CK. West J Emerg Med. 2010;11:358–362.
- Evaluation of a new treatment strategy for Paget-Schroetter syndrome: spontaneous thrombosis of the axillary-subclavian vein. Machleder HI. J Vasc Surg. 1993;17:305–317.
- Savarese RG, Capobianco JD, Adesina AT, Reed G. Robert G. Savarese; 2003. OMT Review: A Comprehensive Review in Osteopathic Medicine, 3rd ed.
- The thoracic outlet syndromes: part 2. The arterial, venous, neurovascular, and disputed thoracic outlet syndromes. Ferrante MA, Ferrante ND. Muscle Nerve. 2017;56:663–673.
- Kimberly PE, Dickey J, Halma KD. Kirksville, MO: A.T. Still University of Health Sciences, Kirksville College of Osteopathic Medicine, Dept. of Osteopathic Manipulative Medicine. Marcelline, MO: Walsworth Publishing; 2006. Outline Of Osteopathic Manipulative Procedures: The Kimberly Manual.
- An osteopathic approach to conservative management of thoracic outlet syndromes. Dobrusin R. . J Am Osteopath Assoc. 1989;89:1046–1057.
Source: PubMed