Adson's sign and the costoclavicular maneuver lack specificity and sensitivity and should make up only a small part of the mandatory comprehensive history and physical examination undertaken with a patient suspected of having<unk> . There is currently no single clinical sign that makes the diagnosis of<unk>  with any degree of certainty. Additional maneuvers that may be abnormal in<unk>  include Wright's Test, which involves hyperabducting the arms over the head with some extension and evaluating for loss of radial pulses or signs of blanching of the skin in the hands indicating a decrease in blood flow with the maneuver. The "compression test" is also used, exerting pressure between the clavicle and medial humeral head causes radiation of pain and/or numbness into the affected arm. Doppler arteriography, with probes at the fingertips and arms, tests the force and "smoothness" of the blood flow through the radial arteries, with and without having the patient perform various arm maneuvers (which causes compression of the subclavian artery at the<unk><unk> . The movements can elicit symptoms of pain and numbness and produce graphs with diminished arterial blood flow to the fingertips, providing strong evidence of impingement of the subclavian artery at the<unk><unk> . Doppler arteriography does not utilize probes at the fingertips and arms, and in this case is likely being confused with plethysmography, which is a different method that utilizes ultrasound without direct visualization of the affected vessels. Doppler ultrasound (not really 'arteriography') would not be used at the radial artery in order to make the diagnosis of<unk> . Finally, even if a Doppler study of the appropriate artery were to be positive, it would not diagnose neurogenic<unk> , by far the most common subtype of<unk> . There is plenty of evidence in the medical literature to show that arterial compression does not equate to brachial plexus compression, although they may occur together, in varying degrees. Additionally, arterial compression by itself does not make the diagnosis of arterial<unk>  (the rarest form of<unk> . Lesser degrees of arterial compression have been shown in normal individuals in various arm positions and are thought to be of little significance without the other criteria for arterial<unk> . MRI scan can show the anatomy of the<unk><unk> , the soft tissues causing compression, and can show directly the brachial plexus compression. Classification By structures affected and symptomatology There are three main types of<unk> , named according to the cause of the symptoms; however, these three classifications have been coming into disfavor because<unk>  can involve all three types of compression to various degrees. The compression can occur in three anatomical structures (arteries, veins and nerves), it can be isolated, or, more commonly, two or three of the structures are compressed to greater or lesser degrees. In addition, the compressive forces can be of different magnitude in each affected structure. Therefore, symptoms can be variable. * Neurogenic<unk>  includes disorders produced by compression of components of the brachial plexus nerves. The neurogenic form of<unk>  accounts for 95% of all cases of<unk> . * Arterial<unk>  is due to compression of the subclavian artery. This is less than one percent of cases. * Venous<unk>  is due to compression of the subclavian vein. This makes up about 4% of cases. By event There are many causes of<unk> . The most frequent cause is trauma, either sudden (as in a clavicle fracture caused by a car accident), or repetitive (as in a legal secretary who works with his/her hands, wrists, and arms at a fast paced desk station with non-ergonomic posture for many years).<unk>  is also found in certain occupations involving much lifting of the arms and repetitive use of the wrists and arms . One cause of arterial compression is trauma, and a recent case involving fracture of the clavicle has been reported. The two groups of people most likely to develop<unk>  are those suffering from neck injuries due to traffic accidents and those who use computers in non-ergonomic postures for extended periods of time.<unk>  is frequently a repetitive stress injury (RSI) caused by certain types of work environments. By structure causing constriction It is also possible to classify<unk>  by the location of the obstruction: * Anterior scalene<unk>  (compression on brachial plexus and/or subclavian artery caused by muscle growth). * Cervical rib<unk>  (compression on brachial plexus and/or subclavian artery caused by bone growth). * Costoclavicular<unk>  (narrowing between the clavicle and the first rib) – diagnosed with the costoclavicular maneuver. Some people are born with an extra incomplete and very small rib above their first rib, which protrudes out into the superior<unk><unk>  space. This rudimentary rib causes fibrous changes around the brachial plexus nerves, inducing compression and causing the symptoms and signs of<unk> . This is called a "cervical rib" because of its attachment to C-7 (the seventh cervical vertebra), and its surgical removal is almost always recommended. The symptoms of<unk>  can first appear in the early teen years as a child is becoming more athletic.
Thoracic outlet syndrome
Fibromyalgia
Central cord syndrome
Rotator cuff tear
Medial medullary syndrome
Complex regional pain syndrome
Cervical spinal stenosis
Multiple sclerosis