[Neurogenic thoracic outlet syndrome: a rare diagnosis in the pediatric population]

Neurogenic thoracic outlet syndrome (NTOS) is a complex diagnosis and a result of compression of the brachial plexus in one or more of three compression zones. In children it is a rare and complex diagnosis resulting in significant disability in daily life activities. Children with NTOS may experience milder complaints then adults with often only a heavy or numb feeling of the arm. Given the lack of recognition for TOS in children and the milder presentation diagnosis is often missed or delayed. The diagnosis NTOS should be more regularly thought of in children with unexplained complaints of the upper extremity. Provocation tests such as the upper limb tension test, Tinel sign, Morleys' sign and the elevated arm stress test can be used as an aid in diagnosing NTOS. We suggest to refer suspected children with NTOS to a TOS expert centre with extensive experience in thoracic outlet decompression.