Thoracic outlet syndrome is the term that refers to compression of the neurovascular bundle at the thoracic inlet (the term ‘thoracic outlet syndrome’ is a misnomer). The syndrome can be classified into three subgroups: venous, arterial and nervous.

It is treated by resection of the cervical rib or fibrous band that is causing the problem. Thrombolysis could be considered in acute thrombosis.

Key points: Thoracic outlet syndrome occurs at one of three sites: (a) the interscalene space (just above the medial first anterior rib); (b) the costoclavicular triangle; (c) the subcoracoid space.

A Pancoast tumor can result in similar symptoms and should be excluded.