Thanks for the assistance, I'll use the search to see what I can find here. Of course we had most ALL of these at OBT before the crash...sigh

Problem is, the abstracts just aren't as specific as I'd like, the articles actually NAME the scalene minimus, which was my major problem, as one of the anomalies that can cause TOS but is present and asymptomatic in many people until they suffer neck trauma. This is what we should have used in my case, but my atty went strictly with local treating Drs as expert witnesses (against my wishes, but I was not in the best condition to stand up to him at the time, the fight to care for my health took every bit of energy), and they could only theorize this could have happened, they had no knowledge if it had actually been proven.

A big drawback in this vaccine court is that I only appear once to testify, other than that appearance I cannot SPEAK at any of these other hearings. It's all between the Special Master and the 2 atty's. And of course I know more about TOS than my atty, but sometimes he won't listen - he thinks because he's read up on it he knows better than I do. Grrr!!

Anyway, so I need the articles in full, the "big names", and in clear, undebateable language, that scalene minimus plus neck trauma can cause TOS. Plus a nice description of scalene anomalies including scalene minimus, along with a illustration if possible, and a good solid description of a proper history and clinical for TOS dx. I'd just like to have them so I won't get anxious, blank out or get overemotional - the papers will do the talking for me, and make this a very simple, but hopefully painful for the opposing counsel, execution.

I WILL be having a glass of wine come Monday noon, that's a sure bet! Thank you all for your replies, it means SO much!!

Jo, I lost tons in a couple crashes - when we first got our new XP system. Problems with everything but the keyboard - monitor was replaced free twice!
That's when I lost all email files and contacts. The hard drive crashes took out my files I hadn't saved to disk. I need a compooper asst!

beth

Just in case anyone wants it here is the link to the msn TOS Articles- I lost the bookmarked link so had to track it down- still can't access the photos or articles - but maybe some day...
http://groups.msn.com/TOSArticles/_whatsnew.msnw

Beth,
I just wondered; if your research is on the anomplies, won;t the unknowledgableJudge feel there was a strong contributory factor in yours and reduce your awrd? If you did not have the anomolies...after all they have no clue.

Also, did you just get a synpsis written from Dr. S or his transcripts to use? Seems these Judges want the small part of the report, not decipher the medical training launguage....
Like reading the synopsis to an article.
I guess I ahve to go back and reread why you need them....
I just saw you wanted them and started searching.
Hugs
Di

my link came from here

there are several good links at this site.

the Brantigan paper directly (all about anomolies) is here

sanders paper on etiology

another web article



Causes

Causes of TOS can be divided into bony and soft tissue factors. Bony factors include abnormalities such as anomalous cervical ribs, hypoplastic first thoracic ribs, and exostoses of the first rib or clavicle (Roos, 1976; Rayan, 1988). The rate of anomalous cervical ribs is considered to be 0.17-0.74% in the general population and the rate of rudimentary first ribs is 0.29-0.76% (Mackinnon, 2002).

Soft tissue factors include congenital anomalies such as anomalous fibrous muscular bands near the brachial plexus and hypertrophic muscles in athletes and weight lifters (Roos, 1976; Esposito, 1997). Space-occupying lesions (eg, tumors, cysts) and inflammatory processes also occur in the soft tissues and can cause TOS.

Trauma or mechanical stress to the neck, shoulders, or upper extremities can lead to TOS. In fact, a combination of neck trauma and anatomic predisposition (ie, cervical rib) is considered the main etiology of TOS. Posttraumatic conditions such as hematoma, myositis ossificans, and scar formation can be important variables, as can a droopy shoulder secondary to trapezius muscle weakness (Al-Shekhlee, 2003). TOS can be secondary to malunion of a clavicle fracture (Fujita, 2001).

Interestingly, multiple points of compression may be present as the peripheral nerves descend from the thoracic outlet to the hand (simultaneous TOS and ulnar nerve compression at the elbow or carpal tunnel syndrome in the wrist). This has been referred to as double- (Upton, 1973) or multiple-crush syndrome (Urschel, 1998).

Hi beth,

I have sent the articles and hope you have received them!! I still have them if you need them you can email me if you have questions.

love and hugs,
Victoria
gibbrn@hotmail.com

Hmm, I don't know what to think about this...

***********************************
"the diagnosis of TOS is a clinical one based on a detailed history and physical examination. This takes time and effort and is often confounded by the patient's research on the internet and emotional problems usually result"

_________________________________________________
"1: Hand Clin. 2004 Feb;20(1):27-36.Links
Diagnosing thoracic outlet syndrome.

Brantigan CO, Roos DB.
Department of Surgery, Presbyterian St. Luke's Medical Center, Historic Gebhard Mansion, 2253 Downing Street, Denver, CO 80205, USA. cbrantigan@drbrantigan.com
Diagnosing and treating thoracic outlet syndrome can be challenging and frustrating. It must be emphasized that the diagnosis of TOS is a clinical one based on a detailed history and physical examination. This takes time and effort and is often confounded by the patient's research on the internet and emotional problems usually resulting from the symptoms and lack of appropriate treatment. Years of inappropriate diagnosis and ineffective therapy take a heavy toll on these patients. Some have psychologic problems to the point that no treatment, no matter how well indicated, will make them well. Some have had symptoms so long that there is permanent neurologic damage. Each patient presents his or her own diagnostic challenge. Solving the problem and providing effective therapy can be rewarding for doctor and patient."
PMID: 15005381 [PubMed - indexed for MEDLINE]

the diagnosis of TOS is a clinical one based on a detailed history and physical examination. This takes time .......

Should have stopped there. This is what Dr Togut said often; frequently and drilled it in...not the later part of that...In fact I remember on the old forum Dr. Togut took time to stop in on occasions and offer advice. He was supportive of any support groups and research patients could fine to understand , educate not only their self, but family and support system.

Di

YOU'RE GOOD!