My previous post may not have made it to the thread. I am both a patient who has been affected by and a vascular surgeon that specializes in tos (for obvious reasons). Just like ntos pec minor syndrome has no objective testing, pec minor syndrome has no real test. I dont care what sanders group says. He made life out of tos surgery and has established some tests that cant be reproduced by others. Only reliable way to establish the diagnosis is by physical exam. This is also complicated by the presence of ntos. When the brachial plexus is irritated at baseline by the scalene muscles upstream. Further compression of that Nerves downstream exacerbates the pain the numbness and tingling sensation( so called double crush). I have personally would never perform pec minor tenotomy until I rule out ntos which is an upstream problem.