Arterial thoracic outlet syndrome is a rare condition with congenital and acquired causes:

• congenital causes:
  • cervical rib
  • aberrant scalenus anterior or intermedius muscles or fibrous bands relating to the muscles
  • bony compression from abnormal transverse process, clavicle or osteochondroma
• acquired causes:
  • tumor / metastatic deposit
  • trauma
  • infection (compression from an abscess)

Radiological investigation:

• cervical spine radiographs
• supplementary thoracic outlet view to clarify the presence of cervical ribs
• MR or CT angiography in the arms up and down positions

Frequently these investigations follow more common MR C-Spine for presumed radicular cause of the patient's symptoms. In some cases, the findings can be confounding due to the high prevalence of disc osteophyte disease in the background population.