Venous thoracic outlet syndrome
The venous thoracic outlet syndrome is the second commonest form of thoracic outlet syndrome (with neurogenic thoracic outlet syndrome being the commonest and the arterial thoracic outlet syndrome being the least common).
Clinical presentation
It may develop suddenly, often after unusual and tiring exercise of the arms with (subclavian vein compression causes upper limb swelling and pain with resultant venous thrombosis (Paget-Schroetter syndrome). Some can present with intermittent venous compression in the absence of thrombosis (McCleery syndrome)
Patient may have swelling of the hands, fingers and arms, as well as heaviness and weakness of the neck and arms.
Veins in the anterior chest wall may appear dilated.
Pathology
The typical site of subclavian vein compression is at the level of the costoclavicular space between the 1 rib, subclavius muscle, and clavicle.
Radiographic assessment
CT angiography / venography
Often performed in arm up and arm down position.
CT is useful to identify and assess underlying factors such as:
- presence of any cervical rib
- presence of any hypertrophic C7 transverse process
- regional rib callus, exostosis or osseous lesion
- presence of a fibrous band
- muscle insertional variation
- supranumerary muscles (e.g. scalenus)
Siehe auch:
Assoziationen und Differentialdiagnosen zu Venous thoracic outlet syndrome:
