Blood vessels and nerves exiting the thorax at the axilla may be compressed, resulting in a thoracic outlet syndrome.
NOTE: The term "thoracic outlet syndrome" is also used for structures entering or leaving the thorax at the neck.
Causes of the compression:
(1) congenital cervical rib
(2) trauma
(3) tumor
Clinical features:
(1) pain (see below)
(2) paresthesias
(3) fatigability in the arm
(4) vascular changes (coldness, color change, Raynaud's syndrome), especially when caused by a change in arm position
(5) brachial plexus tenderness to palpation
(6) sensory and/or motor deficits in the upper extremity
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Location of Pain and Paresthesias
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Nerve Roots
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Site of Compression
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shoulder, neck and radial aspect of arm and forearm
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C5 and C6
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upper brachial plexus
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ulnar aspect of arm and forearm
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C8 and T1
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lower brachial plexus
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