The use of ultrasound in the emergency department for the detection of thoracic outlet syndrome: A single case study

被引:1
|
作者
Tung-Chen, Yale [1 ]
Marin-Baselga, Raquel [1 ]
Tejada-Sorados, Renzo [1 ]
Enfedaque-Castilla, Israel [1 ]
机构
[1] Hosp Univ La Paz, Dept Emergency Med, Paseo Castellana 241, Madrid 28046, Spain
关键词
Point-of-care ultrasonography; thoracic outlet syndrome; nerve compression; upper limb pain; cervical rib;
D O I
10.1177/1742271X20941174
中图分类号
R8 [特种医学]; R445 [影像诊断学];
学科分类号
1002 ; 100207 ; 1009 ;
摘要
Introduction: Thoracic outlet syndrome (TOS) refers to a spectrum of syndromes related to the compression of the brachial plexus (neurogenic TOS), subclavian vein or artery in the general region of the thoracic outlet, which is the area just above the first rib and behind the clavicle. Case report: We report a 27-year-old healthy man who presented to the emergency department with right upper limb pain, tingling and weakness. Point-of-care ultrasonography was performed following a dynamic protocol in the supraclavicular fossa in the right upper limb. A congenital cervical rib, as well as narrowing of the costoclavicular gap, causing vein, artery and spinal roots compression was evidenced. This maneuver reproduced the symptoms, confirming the suspicion of neurogenic TOS. Discussion: Early diagnosis is important, because the neurogenic compression associated with neurogenic TOS, if prolonged, can lead to muscle weakness and atrophy, being irreversible. Selected patients with neurogenic TOS who have progressive weakness, disabling pain, or who have failed to improve with conservative measures are considered for first rib resection. Conclusion: Using the dynamic approach during point-of-care ultrasonography examination, in combination with physical examination and cervical radiography, could help identify neurogenic TOS.
引用
收藏
页码:64 / 66
页数:3
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