Thoracic outlet syndromes and magnetic resonance imaging

• DOI: 10.1093/brain/116.4.823
• Publication Date: 2007-01-04T04:52:09Z
• Authors: Peter K. Panegyres; Niall Moore; Rod Gibson; Geoffrey Rushworth; Michael Donaghy
• Keywords: Cervical rib; Cervical Nerve

The thoracic outlet syndromes encompass the diverse clinical entities affecting branchial plexus or subclavian artery including cervical ribs bands. Thoracic syndrome are often difficult to diagnose on existing and electrophysiological criteria new diagnostic methods necessary. This study reports our experience with magnetic resonance imaging (MRI) of brachial in 20 patients suspected syndrome. distribution pain sensory disturbance varied widely, weakness wasting usually affected C8/T1 innervated muscles, electrophysiology showed combinations reduced nerve action potentials from fourth fifth digits, prolonged F-responses tendon reflex latencies. MRI was interpreted blind. Deviation recorded 19 out 24 symptomatic sides (sensitivity 79%). Absence distortion correctly identified 14 16 asymptomatic (specificity 87.5%). false positive rate 9.5%. Magnetic demonstrated all seven visible plain spine radiographs. also a band-like structure extending C7 transverse process 25 33 sides; similar structures were detected three 18 control subjects. These bands underlay observed patients. We instances by post-traumatic callus first rib, hypertrophied serratus anterior muscle. If they did not demonstrate radiographs had no value predicting distortion. believe be potential diagnosis by: (i) demonstrating deviation nerves blood vessels; (ii) suggesting presence radiographically invisible bands; (iii) disclosing other causes apart