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Postfixed brachial plexus radiculopathy due to thoracic disc herniation in a collegiate wrestler: a case report.
[thoracic outlet syndrome]
To
present
the
unique
case
of
a
collegiate
wrestler
with
C
7
neurologic
symptoms
due
to
T
1
-
T
2
disc
herniation
.
A
23
-
year
-old
male
collegiate
wrestler
injured
his
neck
in
a
wrestling
tournament
match
and
experienced
pain
,
weakness
,
and
numbness
in
his
left
upper
extremity
.
He
completed
that
match
and
1
additional
match
that
day
with
mild
symptoms
.
Evaluation
by
a
certified
athletic
trainer
6
days
postinjury
showed
radiculopathy
in
the
C
7
distribution
of
his
left
upper
extremity
.
He
was
evaluated
further
by
the
team
physician
,
a
primary
care
physician
,
and
a
neurosurgeon
.
Cervical
spine
injury
,
stinger
/
burner
,
peripheral
nerve
injury
,
spinal
cord
injury
,
thoracic
outlet
syndrome
,
brachial
plexus
radiculopathy
.
The
patient
initially
underwent
nonoperative
management
with
ice
,
heat
,
massage
,
electrical
stimulation
,
shortwave
diathermy
,
and
nonsteroidal
anti-
inflammatory
drugs
without
symptom
resolution
.
Cervical
spine
radiographs
were
negative
for
bony
pathologic
conditions
.
Magnetic
resonance
imaging
showed
evidence
of
T
1
-
T
2
disc
herniation
.
The
patient
underwent
surgery
to
resolve
the
symptoms
and
enable
him
to
participate
for
the
remainder
of
the
wrestling
season
.
Whereas
brachial
plexus
radiculopathy
commonly
is
seen
in
collision
sports
,
a
postfixed
brachial
plexus
in
which
the
T
2
nerve
root
has
substantial
contribution
to
the
innervation
of
the
upper
extremity
is
a
rare
anatomic
variation
with
which
many
health
care
providers
are
unfamiliar
.
The
injury
sustained
by
the
wrestler
appeared
to
be
C
7
radiculopathy
due
to
a
brachial
plexus
traction
injury
.
However
,
it
ultimately
was
diagnosed
as
radiculopathy
due
to
a
T
1
-
T
2
thoracic
intervertebral
disc
herniation
causing
impingement
of
a
postfixed
brachial
plexus
and
required
surgical
intervention
.
Athletic
trainers
and
physicians
need
to
be
aware
of
the
anatomic
variations
of
the
brachial
plexus
when
evaluating
and
caring
for
patients
with
suspected
brachial
plexus
radiculopathies
.
Diseases
Validation
Diseases presenting
"pain"
symptom
achondroplasia
acute rheumatic fever
adrenal incidentaloma
adrenomyeloneuropathy
aniridia
aromatase deficiency
carcinoma of the gallbladder
cholangiocarcinoma
coats disease
congenital diaphragmatic hernia
congenital toxoplasmosis
cushing syndrome
cutaneous mastocytosis
cystinuria
dedifferentiated liposarcoma
dentin dysplasia
dracunculiasis
dystrophic epidermolysis bullosa
epidermolysis bullosa simplex
erdheim-chester disease
erythropoietic protoporphyria
esophageal adenocarcinoma
esophageal carcinoma
esophageal squamous cell carcinoma
fabry disease
familial mediterranean fever
focal myositis
hirschsprung disease
hodgkin lymphoma, classical
holt-oram syndrome
junctional epidermolysis bullosa
kabuki syndrome
kindler syndrome
lamellar ichthyosis
liposarcoma
locked-in syndrome
lymphangioleiomyomatosis
malignant atrophic papulosis
neuralgic amyotrophy
oligodontia
oral submucous fibrosis
papillon-lefèvre syndrome
phenylketonuria
pleomorphic liposarcoma
primary hyperoxaluria type 1
proteus syndrome
pyomyositis
scrub typhus
sneddon syndrome
systemic capillary leak syndrome
thoracic outlet syndrome
trochlear dysplasia
typhoid
von hippel-lindau disease
waldenström macroglobulinemia
well-differentiated liposarcoma
wolf-hirschhorn syndrome
This symptom has already been validated