Thoracic outlet syndrome: provocative examination maneuvers in a typical population

Provocative examination maneuvers were assessed in 200 upper extremities of 100 volunteers to determine the prevalence of positive responses in the typical population. The Adson, costoclavicular, and hyperabduction maneuvers were assessed for vascular and neurologic responses. Fifteen (7.5%) extremities had a Tinel's sign. The vascular response was present in 27 (13.5%) extremities for the Adson maneuver, 94 (47%) extremities for the costoclavicular maneuver, and 114 (57%) extremities for the hyperabduction maneuver. The neurologic response was present in 4 (2%) extremities for the Adson maneuver, 20 (10%) extremities for the costoclavicular maneuver, and 33 (16.5%) extremities for the hyperabduction maneuver. The vascular response is more common than the neurologic response in the typical population.