NEURALGIA AND NERVE DISORDERS: DIAGNOSING THORACIC OUTLET SYNDROME

Physicians may use many different tests to determine if you have TOS. Your doctor may have you undergo one or more of the following tests:

· X-rays. The standard X-ray shows bony structure the best.

· Magnetic Resonance Imaging. An MRI scanner may be shaped like a torpedo tube or a four-poster bed and can be very noisy with banging and tapping during the scan. It is sensitive to the hydrogen atoms in water molecules and produces finely detailed pictures of almost all the tissues of the body.

· Angiography. Angiography is an X-ray exam of the arteries and veins to diagnose blockages and other blood vessel problems.

· Arteriography. Arteriography involves injecting a special dye into the bloodstream to make the arteries visible and then taking X-rays to see if they are damaged.

· Venography. Venography involves injecting a special dye into the veins to make them visible and then taking X-rays to see if the veins are damaged.

· Electromyogram (EMG). Occasionally, more information about which nerve is involved is needed and an EMG is ordered. This study uses small needles or skin electrodes to measure the electrical response in muscles related to specific nerves or nerve roots. If the response in the muscle is abnormal, this can give your doctor information about the status of the nerve going to that muscle.

· Nerve Conduction velocity (NVC). NVC tests the speed of impulses through a nerve. The nerve is stimulated with electrodes placed on the skin. The nerve activity is recorded by the electrodes and measures the time it takes for electrical impulses to travel between the electrodes, which allows your doctor to calculate the nerve conduction velocity.

· Computerized Tomography. Known as a CT or CAT (Computerized Axial Tomography) scanner, this instrument is shaped like a big donut and is sensitive to the hardness of tissue. Hard tissue, such as bone, appears white; soft material, such as water, appears black; and tissues of intermediate density are seen as shades of gray. CT scans work best for bone problems.

TOS is usually associated with at least one other medical condition. Other common conditions associated with TOS include: biceps/rotator cuff tendonitis, shoulder impingement syndrome, cervical spine strain, fibromyositis, cervical disc disease, spinal stenosis, cervical arthritis, brachial plexus injury, carpal tunnel syndrome, pectoralis minor syndrome and TMJ abnormalities.