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Bilateral thoracic outlet syndrome: An uncommon presentation of a rare condition in children.
[thoracic outlet syndrome]
We
report
an
adolescent
girl
who
had
left-sided
neurogenic
thoracic
outlet
syndrome
(
TOS
)
due
to
impingement
of
the
scalenus
anterior
muscle
with
bilateral
changes
on
nerve
conduction
studies
and
responded
well
to
surgical
decompression
.
A
13
-
year
-old
Caucasian
girl
presented
with
intermittent
pain
,
swelling
,
erythema
,
tingling
and
numbness
of
the
palmar
aspect
of
her
left
hand
.
Nerve
conduction
studies
revealed
bilateral
ulnar
sensory
and
motor
conduction
abnormalities
,
suggesting
early
compressive
neuropathy
in
the
asymptomatic
arm
as
well
.
She
underwent
surgical
exploration
when
it
was
noted
that
the
scalenus
anterior
itself
was
impinging
on
the
brachial
plexus
.
She
had
a
good
clinical
response
to
scalenectomy
.
The
diagnosis
of
neurogenic
TOS
remains
difficult
as
no
single
test
has
been
accepted
as
a
gold
standard
.
But
,
once
diagnosed
using
clinical
symptoms
,
nerve
conduction
studies
,
electromyography
and
radiological
investigations
,
it
is
a
treatable
condition
with
good
prognosis
.
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