TOS is often the resulting diagnosis after elimination of other possible conditions that cause similar symptoms. These other possible conditions include disc herniations, osteoarthritis, tumors and nerve entrapment syndromes such as carpal tunnel syndrome. Currently discrepancies exist between clinicians about the correct approaches to diagnosis and treatment of TOS. Today's technological advancements can help provide more information about the patient's anatomy, however none can be used for diagnosis alone. MRIs are usually best used for confirmation for the evaluation of the region of interest, however in TOS, findings are frequently inconclusive. One reason for this may be the difficulty to evaluate the extent of a muscle spasm or rib somatic dysfunction and the degree to which it is compressing a nerve structure. (Koknel 2005). X-rays are used to eliminate extra ribs in the cervical region as a cause for symptoms. Anomalous cervical ribs are found in 0.17% to 0.74% each year, however, only 10% of individuals experience TOS symptoms and the onset of these symptoms often relates to cervical spine trauma (Novak, Mackinnon, 2002). The diagnosis of TOS remains to be best based on the patient's subjective complaints, physical examination and the exclusion of other pathologies (Novak, Mackinnon, 2002). Clinical assessment of TOS is best achieved by reproduction of symptoms with compression and special orthopaedic provocative tests that re-produces symptoms based on patient position (Koknel, 2005).