Thoracic outlet syndrome

Case contributed by Brendan Cullinane

Presentation

Obese patient with aching in the right arm, particularly in bed.

Patient Data

Age: 50 years
Gender: Female
Ultrasound

Thoracic outlet syndrome with venous involvement with the arm in a range of positions, including neutral. Compression occurred at the subcoracoid region. There was no evidence of arterial involvement or of venous thrombosis (not shown).

Image 1: dampened flow was demonstrated within the right axillary vein with the arm adducted.

Image 2: compression of the right subclavian vein with aliasing and increased flow velocities was demonstrated at point A in the image in the subcoracoid region. Compression was not demonstrated at the clavicle or scalene muscles (not shown).

Image 3: right subclavian vein compression in the subcoracoid region with the arm in 90 degrees abduction.

Image 4: right subclavian vein compression in the subcoracoid region with the arm in 180 degrees abduction.

Image 5: the subclavian artery waveforms remained normal in the subcoracoid, clavicular and scalene muscle regions (latter 2 not shown) with the arm in a variety of positions.

Case Discussion

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Case information

rID: 18205
Published: 19th Jun 2012
Last edited: 10th May 2019
Inclusion in quiz mode: Included

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