Thoracic outlet syndrome.

"Thoracic outlet syndrome" is a term ascribed to a complex clinical entity encompassing complicated neurovascular signs, symptoms and pathology of the upper extremity. Controversies exist concerning its causes, diagnosis, and treatment despite years of intense study of hundreds of patients. Although there is no universal agreement on the diagnostic and treatment modalities to be applied to each patient, general guidelines have emerged that can aid hand surgeons in recognizing and evaluating these potentially difficult patients. A review of the anatomy, causes, clinical presentations, diagnostic tests, and treatment options available for thoracic outlet syndrome is presented, followed by an illustrative case.