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Pectoralis Minor Syndrome: Subclavicular Brachial Plexus Compression.

Richard J Sanders1, Stephen J Annest2

  • 1The Department of Surgery, University of Colorado Health Science Center, Aurora, Colorado and Presbyterian-St. Lukes Hospital, Denver, CO 80202, USA. rsanders@ecentral.com.

Diagnostics (Basel, Switzerland)
|August 10, 2017
PubMed
Summary

Diagnosing brachial plexus compression, including neurogenic thoracic outlet syndrome (NTOS) and neurogenic pectoralis minor syndrome (NPMS), relies on clinical evaluation and diagnostic blocks. Electrodiagnostic studies aid confirmation but do not establish these nerve compression diagnoses.

Keywords:
NPMSNTOSPMSTOSneurogenic pectoralis minor syndromeneurogenic thoracic outlet syndromenumbness and tinglingoccipital headachepain in neck and armpectoralis minor syndromethoracic outlet syndrome

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Area of Science:

  • Neurology
  • Orthopedics
  • Physical Medicine and Rehabilitation

Background:

  • Brachial plexus compression, encompassing neurogenic thoracic outlet syndrome (NTOS) and neurogenic pectoralis minor syndrome (NPMS), is traditionally diagnosed via clinical history and physical examination.
  • Current diagnostic methods often involve provocative tests and diagnostic blocks of specific muscles, such as the scalene and pectoralis minor muscles, to corroborate clinical suspicion.

Purpose of the Study:

  • To outline the diagnostic process for brachial plexus compression syndromes.
  • To discuss the role of various diagnostic modalities, including clinical assessment, diagnostic blocks, and electrodiagnostic studies.
  • To highlight the importance of considering differential diagnoses for upper extremity pain.

Main Methods:

  • Clinical history and physical examination form the cornerstone of diagnosis.
  • Diagnostic blocks of the scalene and pectoralis minor muscles are utilized for confirmation.
  • Electrodiagnostic studies are employed to support the diagnosis of nerve compression.

Main Results:

  • Diagnosis relies heavily on clinical findings and response to diagnostic blocks.
  • Electrodiagnostic studies can confirm nerve compression but are not definitive for establishing NTOS or NPMS.
  • Differential and associated diagnoses for upper extremity pain must be systematically evaluated.

Conclusions:

  • The diagnosis of NTOS and NPMS is primarily clinical, supported by targeted interventions.
  • A comprehensive approach, including differential diagnosis, is essential for accurate patient management.
  • Both conservative and surgical treatment options are available for these conditions.