Document Detail

Use of sonography in thoracic outlet syndrome due to a dystonic pectoralis minor.
MedLine Citation:
PMID:  19710222     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: For patients with thoracic outlet syndrome (TOS), it is important to determine the location of the neurovascular compression to achieve effective intervention. METHODS: The diagnostic workup for a 39-year-old man with TOS included a selective anesthetic block of the pectoralis minor muscle and duplex sonography before and after the block. RESULTS: The subclavian artery peak systolic flow velocity decreased after the block from 208 to 63 cm/s when the arm was in the abduction and external rotation position, indicating a reduction in the severity of focal arterial compression. Also, the arterial diameter increased by 10% after the block (from 0.80 to 0.88 cm). His level of discomfort was reduced from 6 to 2 on a scale of 1 to 10 (66%). CONCLUSIONS: The pectoralis minor block resulted in an improvement in subclavian artery blood flow and symptoms and confirmed the diagnosis of pectoralis minor TOS. This suggests that selective anesthetic muscle blocks and duplex sonographic studies may be useful before chemodenervation and surgery.
Ib R Odderson; Edward S Chun; Orpheus Kolokythas; R Eugene Zierler
Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Journal of ultrasound in medicine : official journal of the American Institute of Ultrasound in Medicine     Volume:  28     ISSN:  1550-9613     ISO Abbreviation:  -     Publication Date:  2009 Sep 
Date Detail:
Created Date:  2009-08-27     Completed Date:  2009-11-05     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8211547     Medline TA:  J Ultrasound Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1235-8     Citation Subset:  IM    
Department of Rehabilitation Medicine, University of Washington Medical Center, Seattle, 98195, USA.
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MeSH Terms
Dystonia / complications*,  ultrasonography*
Nerve Block / methods*
Pectoralis Muscles / ultrasonography*
Thoracic Outlet Syndrome / etiology*,  ultrasonography*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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