The Role of Diagnostic Imaging for Thoracic Outlet Syndrome Patients

Join Radiologist and Thoracic Outlet Syndrome expert Scott Werden, MD for a free, online discussion of the various diagnostic imaging tools that are currently available to diagnose Thoracic Outlet Syndrome. In this patient friendly discussion, you will learn how each type of imaging tool can assist or act as a barrier to patient recovery. Participant Q + A at the end of event. Join us.
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MRI diagnosis of TOS
Each of the three types of TOS results from a different mechanism. Thus, imaging tests in TOS patients are specialized and focused. Imaging should demonstrate the compressed nerves, arteries or veins, as well as the mechanism of compression.
How do modern imaging tests focus on each type of TOS?
Imaging Diagnosis of Neurogenic TOS
Imaging Diagnosis of Venous TOS
Imaging Diagnosis of Arterial TOS
Imaging Diagnosis of Neurogenic TOS
Patients with neurogenic TOS present a challenge to many doctors, even TOS specialists. Imaging tests specifically designed for patients with neurogenic TOS can confirm or rule out the doctor’s clinical diagnosis. Additionally, MRI can show all the structures of the thoracic outlet, both normal and abnormal, that cause neurogenic TOS.
In the past, doctors have used various tests, ranging from x-rays to direct angiography to CT scans, to help understand this disease. But we firmly believe that MRI provides the greatest diagnostic value for these patients. We would like to help you understand the imaging diagnosis of neurogenic TOS.
IMAGING OF NEUROGENIC TOS
Back to Imaging Overview
Imaging Diagnosis of Venous TOS
Most doctors quickly recognize the signs and symptoms of a patient presenting with venous TOS. A large blood clot blocks blood flow in the veins draining the arm. Arm swelling, color changes, and new superficial veins appear. Since the clinical diagnosis can be made promptly, imaging diagnosis of venous TOS focuses on proving the presence of a blood clot. Imaging can also guide the doctors who dissolve this blood clot. Doctors select from ultrasound, direct venogram, CT, or MRI for this purpose.
Following the urgent treatment of this blood clot, imaging provides detailed information about the structures that initially caused the blood clot. Often, there is a prominent tendon or ligament that compresses and damages the vein in certain arm positions. MRI demonstrates these soft tissues with great detail.
IMAGING OF VENOUS TOS
Back to Imaging Overview
Imaging Diagnosis of Arterial TOS
Patients with arterial TOS frequently present with acute arterial occlusion, which is a surgical emergency. Doctors need to remove this clot and restore blood flow urgently. Imaging tests can prove the presence and extent of the arterial blood clot. Imaging tests also enable doctors to dissolve the clot.
Following emergent restoration of blood flow to the arm, doctors use imaging tests to demonstrate arterial damage, such as an aneurysm or stenosis. Further, imaging tests show the structures outside the artery that caused the damage to begin with. This mechanism may only be apparent with the patient’s arms elevated. Read more about the imaging tests that provide vital information in patients with arterial TOS.

[@carolinep7539]

I'm so grateful that I have found this page! I'll be messaging you.

[@bubba8289]

I am in deep gratitude for you, Dr. Werden, for making this educational video available! Thank you so much for your time and attention to explain it so plainly.

[@tashagee2706]

This is exactly what I was looking for, nothing else I found was so thorough with multiple examples and explanations of each. Thank you!

[@tosmri]

Sorry for the delayed response, @tashagee2706 I am glad to hear we helped you. I hope you follow us, as we have some exciting guests and live streams coming up!

[@annaraylie8149]

Hello. Is it correct of me to understand that if a patient with a compressed blood vessel is being examined with ultrasound having there arm only in neutral downward position is of high risk for a false negative result? Thank you very much for educational and specific information. /Anna.

[@toniprice4394]

Hi I have numb Hands and painful nerve pain down both sore neck

[@daisyoscarshow8368]

Me too with symptoms like ataxia and general nervous system dysfunction when I have a flair up, it's been very painful and disabling, I don't have the extra rib though

[@melissapiacenti6272]

Where can I find a protocol for a Ge 450 1.5 T?....thanks MR Tech

[@tosmri]

Hi, and thanks for the question. We use a proprietary, patented method that is compatible with almost every scanner at 1.5 T and above. We also read every study performed with this protocol.

[@lisahill6075]

I’m at my wits end my neck and chest swells all the time lost function in arms I’ve had mri and mra of neck

[@smcremix8791]

i have TOS! also had the surgeries. 😳

[@realness_rarity]

Did your surgeries fix the problems for you? Did you have bilateral tos ?

[@ssharma861]

Question- for the Mra/mri why would they have me turn my head sideways - towards The injury side?

[@paigewhite1251]

To see if your pulse changes.

[@lw7654]

Are you accepting new patients and if not, do you do over the phone/video consults from someone in another state?? Thank you

[@tosmri]

Yes, we absolutely see new patients. Please reach out to us to learn about our consultation service, at www.tosmri.com/contact-us/

[@lw7654]

Thank you. After my next Dr’s appt I will get in touch! Thank you

[@denniemrozek3488]

Do you know people with Thoracic Outlet Syndrome who developed a movement disorder like walking out of balance after a whiplash car accident? My muscles in my shoulder and neck jerk pulsating my head down on the right side of my body. It is very disabling and a terrible feeling. I gets worse when I use the muscles of the right hand.

[@tosmri]

@denniemrozek3488 We all need a very good sense of balance to be able to walk upright. I am glad you brought this up. Anything that alters the position of the head or upper extremities forces us to change our lumbar spine and pelvis, and thus our walking mechanics. This can lead to pain in the back and legs.

[@toniprice4394]

Had mutiple car accident