Rare Diseases Symptoms Automatic Extraction
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A hand surgeon's advanced experience with thoracic outlet compression syndrome.
[thoracic outlet syndrome]
Although
hand
surgeons
may
often
see
patients
with
arm
and
hand
pain
,
numbness
and
tingling
in
their
practice
,
the
possibility
of
the
presence
of
thoracic
outlet
compression
syndrome
(
TOCS
)
is
not
often
considered
.
In
our
practice
almost
half
of
newly
referred
patients
have
the
complaint
of
upper
extremity
pain
,
numbness
and
tingling
.
In
approximately
50
%
of
these
patients
detailed
history
and
physical
examination
are
suggestive
of
TOCS
.
For
this
reason
it
is
quite
important
to
recognize
the
possibility
of
the
existence
of
this
condition
.
Very
often
in
the
past
,
and
occasionally
today
,
this
condition
has
been
considered
a
controversial
subject
by
numerous
physicians
because
of
the
absence
of
objective
findings
in
many
patients
.
For
several
years
it
has
been
very
well
known
that
the
objective
findings
are
present
in
about
10
%
of
patients
and
the
remaining
90
%
of
patients
have
subjective
complaints
.
For
this
reason
it
has
been
one
of
the
most
commonly
underrated
,
overlooked
,
and
misdiagnosed
conditions
.
During
the
last
22
years
our
experience
with
combined
surgical
approach
for
this
condition
(
transaxillary
first
rib
resection
with
immediate
transcervical
anterior
and
middle
scalenectomy
)
has
been
quite
satisfactory
.
During
these
years
over
850
of
these
procedures
were
performed
.
Between
1989
and
2002
(
13
years
)
532
patients
from
a
wide
geographic
area
had
this
combined
approach
procedure
.
We
were
able
to
locate
358
of
these
patients
for
follow-up
and
of
those
only
102
responded
to
our
questionnaire
.
Of
the
102
who
responded
,
95
reported
improvement
of
their
symptoms
.
From
2003
to
the
middle
of
2012
,
350
patients
from
a
wide
region
had
this
combined
procedure
.
We
sent
a
questionnaire
to
these
patients
and
had
only
57
to
respond
.
Of
those
who
responded
,
there
were
19
bilateral
interventions
performed
a
few
months
apart
,
with
a
total
of
76
procedures
performed
.
Results
based
on
these
76
procedures
revealed
95
%
improvement
of
their
symptoms
.
This
combined
approach
for
TOCS
is
the
most
complete
intervention
with
high
rate
of
improvement
and
low
rate
of
recurrences
.
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
