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Thoracic outlet syndromes in sport: a practical review in the face of limited evidence--unusual pain presentation in an athlete.
[thoracic outlet syndrome]
Despite
thoracic
outlet
syndrome
(
TOS
)
being
first
described
early
in
the
19
th
century
,
the
subsequent
literature
seems
limited
,
focusing
on
case
reports
and
investigations
providing
little
assistance
in
the
management
of
equivocal
presentations
.
Best
practice
clinical
management
,
with
little
evidence
base
,
poses
great
challenges
for
clinicians
in
deciding
how
to
manage
TOS
,
when
to
operate
and
which
procedure
should
be
undertaken
.
Furthermore
,
the
implications
of
TOS
and
its
surgical
effects
are
poorly
documented
,
with
little
evidence
in
the
literature
as
to
the
impact
of
surgical
intervention
on
athletes
and
their
physiology
or
function
.
This
paper
describes
a
clinical
example
of
TOS
highlighting
salient
issues
and
examining
the
evidence
to
guide
clinical
management
at
each
stage
,
in
the
case
of
a
26
-
year
-old
professional
football
player
who
suffered
an
acute
onset
of
unilateral
right
shoulder
to
bicep
pain
associated
with
tingling
in
the
hand
.
Clinicians
managing
similar
cases
in
the
future
will
have
a
reference
point
to
assist
their
diagnosis
,
management
and
promote
much
needed
research
to
further
our
understanding
of
this
difficult
syndrome
.
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