dos Reis Neto Edgard Torres, Pucinelli Mário Luis Cardoso, Silva de Souza Alexandre Wagner, Sato Emília Inoue
Rheumatology Division, Paulista Medical School--Universidade Federal de São Paulo, São Paulo, Brasil.
Acta Reumatol Port. 2009 Jan-Mar;34(1):96-101.
Thoracic outlet syndrome (TOS) is defined as a set of symptoms caused by the compression of the brachial plexus and subclavian vessels in the thoracic outlet region. Anomalies in musculoskeletal structures may be responsible for TOS, including prolonged transverse process of the seventh cervical vertebra, cervical rib, and first anomalous rib and clavicle fractures. The authors describe a case of a young woman with pain in the left forearm, accompanied by intermittent claudication, weigh loss, myalgias and ischemic lesions in the fingers, with no pulses and no measurable blood pressure in the left arm, who was initially diagnosed as Takayasu arteritis. The chest radiography showed accessory cervical ribs and the dynamic vascular image tests (Doppler ultra-sound and angiography) showed bilateral compression of the subclavian artery, confirming the diagnosis of TOS.
胸廓出口综合征(TOS)被定义为一组由胸廓出口区域臂丛神经和锁骨下血管受压引起的症状。肌肉骨骼结构异常可能是TOS的病因,包括第七颈椎横突过长、颈肋、第一肋骨异常和锁骨骨折。作者描述了一例年轻女性病例,该患者左前臂疼痛,伴有间歇性跛行、体重减轻、肌痛和手指缺血性病变,左臂无脉搏且无法测量血压,最初被诊断为大动脉炎。胸部X线检查显示有副颈肋,动态血管影像检查(多普勒超声和血管造影)显示双侧锁骨下动脉受压,确诊为胸廓出口综合征。