Regarding Ke‐Vin Chang et al.’s “Dynamic Ultrasound Imaging of the Brachial Plexus for Diagnosis of Thoracic Outlet Syndrome”

Pain Practice ◽  
2021 ◽  
Author(s):  
Min Cheol Chang ◽  
Kyu Hwan Choi ◽  
Sam‐Guk Park
Keyword(s):  
Brachial Plexus ◽  
Ultrasound Imaging ◽  
Thoracic Outlet Syndrome ◽  
Dynamic Ultrasound

Dynamic Ultrasound Imaging of the Brachial Plexus for Diagnosis of Thoracic Outlet Syndrome

Pain Practice ◽  
2020 ◽  
Author(s):  
Ke‐Vin Chang ◽  
Wei‐Ting Wu ◽  
Yi‐Chiang Yang ◽  
Levent Özçakar
Keyword(s):  
Brachial Plexus ◽  
Ultrasound Imaging ◽  
Thoracic Outlet Syndrome ◽  
Dynamic Ultrasound

Our Surgical Strategy for Thoracic Outlet Syndrome

2018 ◽  
Vol 1 (2) ◽  
Author(s):  
Yasuhiro Nakajima
Keyword(s):  
Brachial Plexus ◽  
Thoracic Outlet Syndrome ◽  
Vascular Compression ◽  
Compression Tests ◽  
Provocation Tests ◽  
Diagnosis Method ◽  
Tunnel Syndrome ◽  
Electrophysiological Examination ◽  
Sensory Neural ◽  
Plexus Block

Surgical treatment for thoracic outlet syndrome (TOS) is a very controversial surgery because objective diagnosis, such as image and electrophysiological examination, is very difficult. Clinical provocation tests including brachial plexus compression tests, such as Morley and Roos, and vascular compression tests, such as Wright and Eden ,are not high in specificity and are likely to be positive even in healthy persons and patients with carpal tunnel syndrome. We place emphasis on the laterality of latency and amplitude in the sensory neural action potential (SNAP) of the medial antebrachial cutaneous nerve and ulnar nerve. After enough stretching exercises of scapular stabilizers and brachial plexus block, we always select surgery. In this presentation, I would like to show our diagnosis method and treatment strategy including surgery.

Ultrasound Imaging of Brachial Plexus: In Reply

2004 ◽  
Vol 100 (5) ◽  
pp. 1326-1327 ◽  
Author(s):  
Anahi Perlas ◽  
Vincent W. S. Chan
Keyword(s):  
Brachial Plexus ◽  
Ultrasound Imaging

scholarly journals Neurogenic Thoracic Outlet Syndrome Caused by Vascular Compression of the Brachial Plexus: A Report of Two Cases

2018 ◽  
Vol 13 (01) ◽  
pp. e1-e3
Author(s):  
Amgad Hanna ◽  
Larry Bodden ◽  
Gabriel Siebiger
Keyword(s):  
Brachial Plexus ◽  
Thoracic Outlet Syndrome ◽  
Vascular Compression ◽  
Repetitive Motion ◽  
Physical Trauma ◽  
Neurogenic Thoracic Outlet Syndrome ◽  
Inferior Portion ◽  
Pass Through ◽  
Neurogenic Tos

AbstractThoracic outlet syndrome (TOS) is caused by compression of the brachial plexus and/or subclavian vessels as they pass through the cervicothoracobrachial region, exiting the chest. There are three main types of TOS: neurogenic TOS, arterial TOS, and venous TOS. Neurogenic TOS accounts for approximately 95% of all cases, and it is usually caused by physical trauma (posttraumatic etiology), chronic repetitive motion (functional etiology), or bone or muscle anomalies (congenital etiology). We present two cases in which neurogenic TOS was elicited by vascular compression of the inferior portion of the brachial plexus.

High-definition ultrasound imaging defines the paraneural sheath and fascial compartments surrounding the cords of the brachial plexus at the costoclavicular space and lateral infraclavicular fossa

2021 ◽  
pp. rapm-2020-102304
Author(s):  
Pornpatra Areeruk ◽  
Manoj Kumar Karmakar ◽  
Miguel A Reina ◽  
Louis Y H Mok ◽  
Ranjith Kumar Sivakumar ◽  
...  
Keyword(s):  
Brachial Plexus ◽  
Ultrasound Imaging ◽  
Brachial Plexus Block ◽  
Ultrasound Images ◽  
High Definition ◽  
Link Type ◽  
Before And After ◽  
Registration Number ◽  
Local Anesthetic Injection ◽  
Plexus Block

Background and objectivesThe paraneural sheath is a multilayered network of collagen fibers that surround the brachial plexus. Currently, there are no sonographic data on the paraneural sheath of the brachial plexus, which this study aimed to evaluate.MethodsUltrasound imaging datasets of 100 patients who received a costoclavicular brachial plexus block, using high-definition ultrasound imaging, were retrospectively reviewed. Video files, representing sonograms before and after the local anesthetic injection, from the costoclavicular space and lateral infraclavicular fossa were collated and reviewed by three experienced anesthesiologists. Frequency (yes/no) of ultrasound visualization of the paraneural sheath, septum, and the anterior and posterior compartments was assessed. Representative sonograms from the costoclavicular space and lateral infraclavicular fossa were visually correlated with archived cadaver microanatomic sections from the same location.ResultsDatasets of the 98 patients who achieved surgical anesthesia were evaluated. The paraneural sheath, septum, and the anterior and posterior compartments were visualized in 17.3%, 7.1%, 5.1% and 5.1%, respectively, at the costoclavicular space before the brachial plexus block; this contrasts (p<0.001) with their visibility post-block (94.9%, 75.5%, 75.5% and 75.5%, respectively). At the lateral infraclavicular fossa, the corresponding visibility of these structures post-block were 67.7%, 81.5%, 81.5% and 81.5%, respectively. Ultrasound images of the paraneural sheath and septum correlated well with that in the cadaver microanatomic sections.ConclusionWe have demonstrated the paraneural sheath and fascial compartments surrounding the cords of the brachial plexus at the costoclavicular space and lateral infraclavicular fossa using high-definition ultrasound imaging.Trial registration numberClinicalTrials.gov Registry (NCT04370184), (https://www.clinicaltrials.gov/).

Conservative Treatment of Thoracic Outlet Syndrome Using an Orthosis

1995 ◽  
Vol 20 (1) ◽  
pp. 34-39 ◽  
Author(s):  
Y. NAKATSUCHI ◽  
S. SAITOH ◽  
M. HOSAKA ◽  
S. MATSUDA
Keyword(s):  
Conservative Treatment ◽  
Activities Of Daily Living ◽  
Brachial Plexus ◽  
Daily Living ◽  
Thoracic Outlet Syndrome ◽  
Shoulder Girdle ◽  
Neurological Deficits ◽  
Sensory Disturbance ◽  
Motor Disturbance

We describe a strapping device for elevation of the shoulder in patients with thoracic outlet syndrome (TOS). The device was used by 86 patients with TOS whose symptoms had been alleviated by passively raising the shoulder. Symptoms of TOS were classified as proximal, including pain in the shoulder girdle, and distal, in which there were neurological deficits related to the brachial plexus. The device was more effective in patients with distal symptoms: pain disappeared or improved in 67% of patients; numbness in 85%; sensory disturbance in 84%; and motor disturbance in 80%. However, proximal symptoms were relieved in only 65% of the patients. The ability to perform activities of daily living was rated as excellent in 33% of patients, good in 44%, fair in 12%, and poor in 9%. The shoulder orthosis described in this report can counterbalance downward traction on the brachial plexus and reduce the tension on it, thereby relieving symptoms of TOS.

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