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The enigma of neurogenic thoracic outlet syndrome following motor vehicle collisions

Canadian Journal of Surgery, 2016-08, Vol.59 (4), p.276-280 [Peer Reviewed Journal]

Joule Inc. or its licensors ;COPYRIGHT 2016 Joule Inc. ;Copyright 8872147 Canada Inc. Aug 2016 ;2016 Joule Inc. or its licensors 2016 ;ISSN: 0008-428X ;EISSN: 1488-2310 ;DOI: 10.1503/cjs.009814 ;PMID: 27454840 ;CODEN: CJSUAX

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Title:
The enigma of neurogenic thoracic outlet syndrome following motor vehicle collisions
Author: Munro, A. Ian, MBBS ; McPherson, G. Duncan, MD, PhD
Subjects: Accidents, Traffic ; Adult ; Carpal tunnel syndrome ; Diagnosis ; Diagnostic Errors - statistics & numerical data ; Diseases ; Electromyography ; Female ; Humans ; Influence ; Male ; Medical examination ; Periodic health examinations ; Physical diagnosis ; Risk factors ; Studies ; Surgery ; Thoracic outlet syndrome ; Thoracic Outlet Syndrome - diagnosis ; Thoracic Outlet Syndrome - epidemiology ; Thoracic Outlet Syndrome - etiology ; Traffic accidents ; Traffic accidents & safety
Is Part Of: Canadian Journal of Surgery, 2016-08, Vol.59 (4), p.276-280
Description: Background The concept of neurogenic thoracic outlet syndrome (N-TOS) including upper and lower plexus syndromes secondary to soft tissue neck injury after motor vehicle collisions (MVCs) has been contentious. We considered that analysis of objective data from this group of patients could provide insight into this controversial type of N-TOS. Methods During the 10-year period January 2001 through December 2010 we examined patients who had received a diagnosis of N-TOS following an MVC. We graded the principal diagnosis based on the objective data from our physical examination. Results In total 263 patients received a diagnosis of N-TOS during the study period. At the highest accuracy level of diagnosis there were 56 patients with ulnar entrapment syndrome (UES), 40 with carpal tunnel syndrome (CTS) and 55 with nonorganic disease (NOD), for a total of 151 (57.4%) cases in which the diagnosis of N-TOS was brought into question. The elevated arm stress test (EAST) reproduced the symptoms of UES in 33 of the 56 patients of UES (58.9%) and reproduced the symptoms of CTS in 18 of the 40 patients with CTS (45.0%). Conclusion There appears to be a high incidence of misdiagnosis of N-TOS following MVCs. The EAST is not a prime test for N-TOS.
Publisher: Canada: Joule Inc
Language: English
Identifier: ISSN: 0008-428X
EISSN: 1488-2310
DOI: 10.1503/cjs.009814
PMID: 27454840
CODEN: CJSUAX
Source: Open Access: PubMed Central
Geneva Foundation Free Medical Journals at publisher websites
AUTh Library subscriptions: ProQuest Central
MEDLINE
Alma/SFX Local Collection

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The enigma of neurogenic thoracic outlet syndrome following motor vehicle collisions

Joule Inc. or its licensors ;COPYRIGHT 2016 Joule Inc. ;Copyright 8872147 Canada Inc. Aug 2016 ;2016 Joule Inc. or its licensors 2016 ;ISSN: 0008-428X ;EISSN: 1488-2310 ;DOI: 10.1503/cjs.009814 ;PMID: 27454840 ;CODEN: CJSUAX

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