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Investigations for thoracic outlet syndrome may include:

  • blood pressure:
    • lower on the affected side
    • variable with arm abduction

  • X-ray:
    • a bony cervical rib may be seen directly
    • a fibrous band is indicated by an enlarged anterior tubercle of the seventh cervical vertebra
    • apical lung tumour in Pancoast's syndrome

  • nerve conduction / electromyography:
    • distinguishes thoracic outlet syndrome from other peripheral nerve lesions

  • arteriography:
    • long standing compression of the subclavian artery may result in a post-stenotic dilatation
    • abduction and external rotation of the shoulder may cause complete obstruction of subclavian blood flow in cases associated with a cervical rib

Last reviewed 01/2018