Clinical case of a patient with Thoracic outlet syndrome
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Keywords

Thoracic outlet syndrome
Raynaud's disease
May-Thurner syndrome

How to Cite

Dimova, Z., Boyadzhieva, V., Emin, S., & Stoilov, N. (2023). Clinical case of a patient with Thoracic outlet syndrome. Rheumatology (Bulgaria), 30(4), 65-73. https://doi.org/10.35465/30.4.2022.pp65-73

Abstract

Thoracic outlet syndrome (TOS) is a group of conditions that result in compression of the brachial plexus, causing symptoms of pain, muscle weakness, and numbness in the shoulders and upper extremities. The classification of TOS is based on pathophysiological symptoms and is mainly divided into neurogenic (nTOS), venous (vTOS) and arterial (aTOS). Depending on the etiology, TOC can be classified as congenital, traumatic, or functionally acquired.

We present a clinical case of a 34-year-old man who was admitted to the Rheumatology Clinic, UMBAL "St. Ivan Rilski" in July 2022. The patient reports complaints of numbness in the fingers, weakness of the upper extremities when the arms are raised, and periungual bruising. The patient underwent phlebography in 2021, with the conclusion of compression of v.subclavia dextra et sinistra during abduction and ipsilateral rotation of the head. From the performed CT-angiography, compression of the right common iliac artery on the left common iliac vein was found, which was dilated, corresponding to the highest degree with May-Turner syndrome. In the rheumatology clinic, capillaroscopy was performed, which visualized peripheral vascular spasm and nonspecific changes. Laboratory and immunological tests did not reveal any abnormalities.

https://doi.org/10.35465/30.4.2022.pp65-73
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