Thoracic outlet syndrome
Vague neuropathic symptoms in the left arm. History of a motor vehicle accident.
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Compression of the left subclavian artery beneath the clavicle with the patient's arm in extreme abduction, suggesting thoracic outlet syndrome with arterial involvement.
Image 1: left subclavian artery waveform with the arm adducted and at rest.
Image 2: with the arm in extreme abduction, the velocity within the left subclavian artery more than triples at the lateral edge of the clavicle, suggesting compression beneath the clavicle. There was no evidence of compression in the subcoracoid region or at the scalene muscles (not shown).
Image 3: marked damping of the waveform in the lateral left subclavian artery with the arm in extreme abduction.