Originally Posted by LiveLoveandTrust

Rebelette, a Doppler test is an ultrasound of the artery and vein in the thoracic outlet. They have you move your arm in different provocative ways to see if they can see the vein or artery constrict. If they see this consistently, they diagnose vascular thoracic outlet syndrome. There is no real solid way to diagnose disputed neurogenic TOS. They do the best they can by doing provocative testing and perhaps a scalene or pec minor block because when they do those blocks if your symptoms disappear than it's indicative that there is some compression of the nerve going on in there. True neurogenic TOS is an easy diagnosis because the only real difference between disputed and true neurogenic is wasting of the fat pad at the base of your thumb. It's quite noticeable. From what I understand, when you are diagnosed with arterial, true neurogenic or moderate-severe venous TOS you pretty much need surgery at that point though not everyone has the same experience. Physical therapy is always tried first unless there is a medical concern that needs to be addressed. For example, until they found out that I had arterial involvement, I had been sent to many rounds of PT. Now that they found that the artery is being constricted they ideally want surgery within a week of me seeing the doctor on Friday.
I wish you the best of luck!!