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Thoracic outlet syndrome--aspects of diagnosis in the differential diagnosis of hand-arm vibration syndrome Cooke RAOccup Med (Lond) 2003[Aug]; 53 (5): 331-6BACKGROUND: Thoracic outlet syndrome (TOS) is a cause of vascular and neurological compromise to the arm and hand, and may manifest as Raynaud's phenomenon. It may be under-diagnosed. AIM: This review was undertaken in order to clarify the diagnostic and investigative features of TOS that may differentiate it from hand-arm vibration syndrome. METHODS: A tiered review of the world literature was undertaken using Medline and Embase as the primary search engines. CONCLUSION: Thoracic outlet syndrome most commonly presents with neurological symptoms in the arm. Vascular symptoms, including Raynaud's phenomenon, may occur in approximately 10% of cases. Careful clinical assessment by history and examination may reveal the elements of forearm and upper arm symptoms with postural exacerbation, which distinguish this condition from hand-arm vibration syndrome. The usefulness of investigation is unclear, but Doppler and neuroelectric studies may be valuable. Magnetic resonance imaging scan is the investigation of choice.|Arm[MESH]|Arm Injuries/*diagnosis[MESH]|Cumulative Trauma Disorders/*diagnosis[MESH]|Diagnosis, Differential[MESH]|Hand Injuries/*diagnosis[MESH]|Humans[MESH]|Magnetic Resonance Imaging[MESH]|Peripheral Nervous System Diseases/diagnosis/etiology[MESH]|Peripheral Vascular Diseases/diagnosis/etiology[MESH]|Risk Factors[MESH]|Syndrome[MESH]|Thoracic Outlet Syndrome/*diagnosis[MESH]|Vibration/*adverse effects[MESH] |
