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Pulse oximetry measurements in the evaluation of patients with possible thoracic outlet syndrome.
MedLine Citation:
PMID:  23174071     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
PURPOSE: We present our experience in using pulse oximetry as an aid in the diagnosis of thoracic outlet syndrome (TOS). Our attention was given to those symptomatic patients without objective confirmatory data on imaging or electrodiagnostic evaluation.
METHODS: Using a pulse oximeter, we measured the oxygen saturation and the pulse rate during a provocative extremity abduction stress test exercise maneuver in 18 patients with symptoms and signs consistent with a diagnosis of nonspecific neurogenic TOS. The oxygen saturation and pulse rates in 18 asymptomatic subjects were used as a control.
RESULTS: Resting oxygen saturation above 97% was present in both groups initially. After the provocative exercise maneuver, there was a significant reduction in the oxygen saturation levels, which dropped to 86% in the symptomatic TOS group compared with 94% in the control group. There was a significant increase in pulse rate in those subjects suspected of having TOS compared with a minimal increase in pulse rate in control subjects.
CONCLUSIONS: Pulse oximetry produced objective confirmatory measurements, which support a hypothesis that hypoperfusion in the upper limb during provocative activities or exercise may cause disabling symptoms associated with nonspecific neurogenic TOS. This method may be a useful, noninvasive, rapid, and inexpensive clinical tool in the diagnosis of TOS, a condition frequently lacking in objective, confirmatory diagnostic data.
TYPE OF STUDY/LEVEL OF EVIDENCE: Diagnostic III.
Authors:
Richard M Braun; Mark Rechnic; Kalpit N Shah
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The Journal of hand surgery     Volume:  37     ISSN:  1531-6564     ISO Abbreviation:  J Hand Surg Am     Publication Date:  2012 Dec 
Date Detail:
Created Date:  2012-11-23     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7609631     Medline TA:  J Hand Surg Am     Country:  United States    
Other Details:
Languages:  eng     Pagination:  2564-9     Citation Subset:  IM    
Copyright Information:
Copyright © 2012 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved.
Affiliation:
Department of Orthopaedic Surgery, University of California, San Diego, California, and the School of Medicine, University of California, Irvine. Electronic address: rbraun@handsrus.com.
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