Evaluation of Patients with Neurogenic Thoracic Outlet Syndrome.

Neurogenic thoracic outlet syndrome (NTOS) results from the compression or irritation of the brachial plexus within the thoracic outlet. The associated symptoms result in significant disability and negative effects on patient health-related quality of life. The diagnosis of NTOS, despite being the most common type of TOS, remains challenging for surgeons, in part due to the nonspecific symptoms and lack of definitive diagnostic testing. In this article, we present the essential components of the evaluation of patients with NTOS including a thorough history and physical examination, stress maneuvers, diagnostic and therapeutic imaging, and assessment of disability using standardized patient-centered instruments.