Thoracic Outlet Syndrome Thoracic Outlet Syndrome/Brachial Plexopathy. In Memory Of DeAnne Marie.


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Old 10-12-2013, 12:43 AM #1
cyclist cyclist is offline
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Default 20% will lose pulse in Adson maneuver

I've been really struggling with the lack of objective, definitive diagnostic tests for neuro TOS.

This week, I had a doctor tell me that roughly 20% of the population (1 in 5) has anatomy such that they will lose their pulse in the Adson maneuver, and other provocative positions that are sometimes used to "test" for TOS.

Seems to me that these positional tests done in clnical exams are FAR from diagnostic or reliable. They only 'suggest' that you have anatomy which may predispose you to getting TOS.

Anyone have any thoughts? comments? dissenting info? Would love to hear it...
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Old 10-12-2013, 11:37 AM #2
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Quote:
Originally Posted by cyclist View Post
I've been really struggling with the lack of objective, definitive diagnostic tests for neuro TOS.

This week, I had a doctor tell me that roughly 20% of the population (1 in 5) has anatomy such that they will lose their pulse in the Adson maneuver, and other provocative positions that are sometimes used to "test" for TOS.

Seems to me that these positional tests done in clnical exams are FAR from diagnostic or reliable. They only 'suggest' that you have anatomy which may predispose you to getting TOS.

Anyone have any thoughts? comments? dissenting info? Would love to hear it...
I think most drs mine anyway will dx tos by doing Ct scan w contrast to see if u have abnormal bony anatomy that is narrowing the outlet. They cant really see scar tissue til they go in w knife. Also they rely on ur physical sx and what activities of daily living increase ur pain n where ur numbness is located. If the antebrachialcutaneous n. is slowing thisis a good sign too. My Dr doesn't rely on botox for dx cause doesn't help everyone w tos espec if u have abnormal bony anatomy. But he will recommend u try botox to see if u can get some relief. I also think drs need. the. Neg results to get the ins. Co to approve tos surgeries, just my opinion.
Hope this helps u!
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Old 10-12-2013, 12:41 PM #3
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Yes, the pulse checks are only a possible indicator, not a decisive test.

A full history & detailed symptoms listed will be an additional help to drs.
It is so easy to feel rushed and not recall every symptom, or dr may not catch everything mentioned..

Most drs will do many tests to rule in or out any other possible dx.

Thyroid and other blood work is usually done also..
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