Grade C evidence exists for the use of these clinical diagnostic tests to exclusively diagnose thoracic outlet syndrome.Īdson’s test Healstead manuever sensitivity specificity upper extremity pathology. Strength of Recommendation: Grade B evidence exists to support the accuracy of the Halstead maneuver, Wright's test, Cyriax Release test, and supraclavicular pressure test for the diagnosis of upper extremity pathology in general. The use of the Adson's test and Roos test should be discontinued for the differential diagnosis of thoracic outlet syndrome. However, these clinical diagnostic tests do not appear to allow for the differential diagnosis of thoracic outlet syndrome exclusively. Sometimes, a local anesthetic injection near the neck can help localise the pressure site. Generally, tests such as MRI of the neck and outlet, nerve studies, and blood vessel studies are done. In thoracic outlet syndrome and specifically vascular TOS, one possible cause can be the compression of the subclavian artery or vein as it passes through the interscalene triangle by the muscle bodies of the. Clinical Bottom Line: There is moderate evidence to support the use of the Halstead maneuver (also known as the costoclavicular maneuver or exaggerated military brace test), Wright's test, Cyriax Release test, and supraclavicular pressure test to have good diagnostic accuracy for the provocation of symptoms in patients presenting with upper extremity pathology. Also, nerve testing is essential to look for a pinched nerve and other causes of your symptoms. The Allen test is part of the diagnostic work-up for vascular abnormalities of the upper limb such as in thoracic outlet syndrome (TOS). One study reported that clinical diagnostic test findings correlate to provocative positioned magnetic resonance imaging findings. One study reported high false-positive rates among clinical diagnostic tests for thoracic outlet syndrome. Two studies supported the use of clinical diagnostic tests for the diagnosis of thoracic outlet syndrome. However, controversy exists over which diagnostic procedures produce accurate findings.Ĭan clinical diagnostic tests accurately diagnose patients presenting with symptoms of thoracic outlet syndrome? Summary of Key Findings: A thorough literature search returned 6 possible studies 3 studies met the inclusion criteria and were included. Currently, there are myriad diagnostic procedures used in the diagnosis of all types of thoracic outlet syndrome. Clinical Scenario: Thoracic outlet syndrome is quite challenging to diagnose.
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