TOS
MCID: THR013
MIFTS: 45

Thoracic Outlet Syndrome (TOS)

Categories: Cardiovascular diseases, Rare diseases

Aliases & Classifications for Thoracic Outlet Syndrome

MalaCards integrated aliases for Thoracic Outlet Syndrome:

Name: Thoracic Outlet Syndrome 12 73 53 58 42 44 15 17 70
Tos 20 58
Thoracic Outlet Compression Syndrome 58
Tos - Thoracic Outlet Syndrome 12
Thoracic Outlet Syndromes 20

Classifications:



External Ids:

Disease Ontology 12 DOID:3103
MeSH 44 D013901
NCIt 50 C85188
SNOMED-CT 67 2040007
ICD10 32 G54.0
MESH via Orphanet 45 D013901
ICD10 via Orphanet 33 G54.0
UMLS via Orphanet 71 C0039984
Orphanet 58 ORPHA97330
UMLS 70 C0039984

Summaries for Thoracic Outlet Syndrome

NINDS : 53 TOS is an umbrella term that encompasses three related syndromes that involve compression of the nerves, arteries, and veins in the lower neck and upper chest area and cause pain in the arm, shoulder, and neck.  Most doctors agree that TOS is caused by compression of the brachial plexus or subclavian vessels as they pass through narrow passageways leading from the base of the neck to the armpit and arm, but there is considerable disagreement about its diagnosis and treatment. Making the diagnosis of TOS even more difficult is that a number of disorders feature symptoms similar to those of TOS, including rotator cuff injuries, cervical disc disorders, fibromyalgia, multiple sclerosis, complex regional pain syndrome, and tumors of the syrinx or spinal cord.  The disorder can sometimes be diagnosed in a physical exam by tenderness in the supraclavicular area, weakness and/or a "pins and needles" feeling when elevating the hands, weakness in the fifth ("little") finger, and paleness in the palm of one or both hands when the individual raises them above the shoulders, with the fingers pointing to the ceiling.  Symptoms of TOS vary depending on the type. Neurogenic TOS has a characteristic sign, called the Gilliatt-Sumner hand, in which there is severe wasting in the fleshy base of the thumb.  Other symptoms include paresthesias (pins and needles sensation or numbness) in the fingers and hand, change in hand color, hand coldness, or dull aching pain in the neck, shoulder, and armpit.  Venous TOS features pallor, a weak or absent pulse in the affected arm, which also may be cool to the touch and appear paler than the unaffected arm.  Symptoms may include numbness, tingling, aching, swelling of the extremity and fingers, and weakness of the neck or arm.  Arterial TOS most prominently features change in color and cold sensitivity in the hands and fingers, swelling, heaviness, paresthesias and poor blood circulation in the arms, hands, and fingers. There are many causes of TOS, including physical trauma, anatomical defects, tumors that press on nerves, poor posture that causes nerve compression, pregnancy, and repetitive arm and shoulder movements and activity, such as from playing certain sports.   TOS is more common in women.  The onset of symptoms usually occurs between 20 and 50 years of age.  Doctors usually recommend nerve conduction studies, electromyography, or imaging studies to confirm or rule out a diagnosis of TOS.

MalaCards based summary : Thoracic Outlet Syndrome, also known as tos, is related to thrombosis and intermittent claudication, and has symptoms including seizures, tremor and back pain. An important gene associated with Thoracic Outlet Syndrome is SERPINC1 (Serpin Family C Member 1), and among its related pathways/superpathways are Formation of Fibrin Clot (Clotting Cascade) and Complement and coagulation cascades. The drugs Acetylcholine and Neurotransmitter Agents have been mentioned in the context of this disorder. Affiliated tissues include spinal cord, heart and bone, and related phenotypes are paresthesia and muscle weakness

Disease Ontology : 12 A vascular disease that is characterized by compression at the superior thoracic outlet[1] resulting from excess pressure placed on a neurovascular bundle passing between the anterior scalene and middle scalene muscles.

GARD : 20 Thoracic outlet syndromes (TOSs) are a group of disorders with one common feature: the compression of 1 or more of the nerves and/or blood vessels just above the first rib and behind the collarbone. There are 4 recognized subtypes of TOS, each with a distinct cause and pattern of symptoms. A fifth subtype is controversial. While thoracic outlet syndromes as a group are not rare, individual subtypes of TOS are considered rare. The subtypes include: Arterial TOS (A-TOS) - due to compression of the subclavian artery, most commonly caused by a cervical rib. Symptoms may include blood clots, arm pain with exertion, or acute arterial thrombosis (sudden blood flow obstruction in an artery). Venous TOS (V-TOS) - due to compression of the subclavian vein, often associated with repetitive arm activities. It may cause pain, swelling, and deep vein thrombosis. Traumatic neurovascular TOS - occurs after trauma to the collarbone and may affect both nerves and vessels. Symptoms may include pain, swelling, bruising, weakness, and loss of sensation in the arm and hand. True neurogenic TOS (TN-TOS) - caused by compression of the brachial plexus. Symptoms include numbness, abnormal sensations, and weakness of the arms and shoulders, as well as pain in the neck, shoulder or hand. Disputed TOS - the vast majority of neurogenic cases. It is controversial whether it is a true form of TOS because it lacks a consistent physical abnormality, a recognized cause, consistent symptoms, a reliable method of testing, and a standard treatment. Pain and tingling or numbness in the neck, arm and hand are common complaints. Treatment for TOS depends on the type and whether symptoms are present. Treatment may involve physical therapy, oral or injected medication (e.g. pain medicine or steroids), thoracic outlet decompression surgery, and/or thrombolytic therapy.

MedlinePlus : 42 Thoracic outlet syndrome (TOS) causes pain in the shoulder, arm, and neck. It happens when the nerves or blood vessels just below your neck are compressed, or squeezed. The compression can happen between the muscles of your neck and shoulder or between the first rib and collarbone. You may feel burning, tingling, and numbness along your arm, hand, and fingers. If a nerve is compressed, you may also feel weakness in your hand. If a vein is compressed, your hand might be sensitive to cold, or turn pale or bluish. Your arm might swell and tire easily. TOS is more common in women. It usually starts between 20 and 50 years of age. Doctors do nerve and imaging studies to diagnose it. There are many causes of TOS, including Injury Anatomical defects Tumors that press on nerves Poor posture that causes nerve compression Pregnancy Repetitive arm and shoulder movements and activity, such as from playing certain sports Treatment depends on what caused your TOS. Medicines, physical therapy, and relaxation might help. Surgery may also be an option. Most people recover. NIH: National Institute of Neurological Disorders and Stroke

Wikipedia : 73 Thoracic outlet syndrome (TOS) is a condition in which there is compression of the nerves, arteries, or... more...

Related Diseases for Thoracic Outlet Syndrome

Diseases related to Thoracic Outlet Syndrome via text searches within MalaCards or GeneCards Suite gene sharing:

(show top 50) (show all 289)
# Related Disease Score Top Affiliating Genes
1 thrombosis 30.9 SERPINC1 PLG F2
2 intermittent claudication 30.3 SERPINC1 F2
3 intracranial hypotension 30.3 SERPINC1 F2
4 intracranial embolism 30.2 SERPINC1 PLG F2
5 post-thrombotic syndrome 30.2 SERPINC1 PLG F2
6 disseminated intravascular coagulation 29.8 SERPINC1 PLG F2
7 neuromuscular disease 29.5 KIF1B GARS1 BSCL2
8 neurogenic thoracic outlet syndrome 11.5
9 venous thoracic outlet syndrome 11.5
10 arterial thoracic outlet syndrome 11.5
11 peripheral nervous system disease 11.2
12 cervical rib 11.0
13 myxoid liposarcoma 10.9
14 paresthesia 10.7
15 carpal tunnel syndrome 10.6
16 plexopathy 10.5
17 pneumothorax 10.5
18 subclavian artery aneurysm 10.5
19 raynaud phenomenon 10.5
20 brachial plexus lesion 10.4
21 virus-associated trichodysplasia spinulosa 10.4
22 limb ischemia 10.3
23 radiculopathy 10.3
24 whiplash 10.3
25 toxic oil syndrome 10.3
26 aneurysm 10.3
27 spinal cord infarction 10.3 SERPINC1 F2
28 lateral sinus thrombosis 10.3 SERPINC1 F2
29 giant hemangioma 10.3 SERPINC1 F2
30 dic in newborn 10.3 SERPINC1 F2
31 waterhouse-friderichsen syndrome 10.3 SERPINC1 F2
32 cavernous sinus thrombosis 10.3 SERPINC1 F2
33 hepatic infarction 10.3 SERPINC1 F2
34 abducens nerve disease 10.3 SERPINC1 F2
35 prothrombin deficiency, congenital 10.3 SERPINC1 F2
36 prothrombin deficiency 10.3 SERPINC1 F2
37 mastoiditis 10.3 SERPINC1 F2
38 hepatic coma 10.3 SERPINC1 F2
39 lipomatosis, multiple 10.3
40 pectus excavatum 10.3
41 cyanosis, transient neonatal 10.3
42 fibrous dysplasia 10.3
43 pleomorphic lipoma 10.3
44 splenic infarction 10.3 SERPINC1 F2
45 pituitary adenoma 5, multiple types 10.3 SERPINC1 F2
46 vitamin k deficiency bleeding 10.3 SERPINC1 F2
47 esophageal varix 10.3 SERPINC1 F2
48 papilledema 10.3 SERPINC1 F2
49 sneddon syndrome 10.2 SERPINC1 F2
50 peripheral vertigo 10.2 SERPINC1 F2

Graphical network of the top 20 diseases related to Thoracic Outlet Syndrome:



Diseases related to Thoracic Outlet Syndrome

Symptoms & Phenotypes for Thoracic Outlet Syndrome

Human phenotypes related to Thoracic Outlet Syndrome:

58 31 (show all 11)
# Description HPO Frequency Orphanet Frequency HPO Source Accession
1 paresthesia 58 31 hallmark (90%) Very frequent (99-80%) HP:0003401
2 muscle weakness 58 31 frequent (33%) Frequent (79-30%) HP:0001324
3 arthralgia 58 31 frequent (33%) Frequent (79-30%) HP:0002829
4 myalgia 58 31 frequent (33%) Frequent (79-30%) HP:0003326
5 abnormality of the ribs 58 31 frequent (33%) Frequent (79-30%) HP:0000772
6 edema 58 31 frequent (33%) Frequent (79-30%) HP:0000969
7 venous thrombosis 58 31 occasional (7.5%) Occasional (29-5%) HP:0004936
8 emg abnormality 58 31 occasional (7.5%) Occasional (29-5%) HP:0003457
9 varicose veins 58 31 occasional (7.5%) Occasional (29-5%) HP:0002619
10 muscle spasm 58 31 occasional (7.5%) Occasional (29-5%) HP:0003394
11 sensory neuropathy 58 Occasional (29-5%)

UMLS symptoms related to Thoracic Outlet Syndrome:


seizures; tremor; back pain; headache; syncope; pain; chronic pain; sciatica; vertigo/dizziness; sleeplessness

MGI Mouse Phenotypes related to Thoracic Outlet Syndrome:

46
# Description MGI Source Accession Score Top Affiliating Genes
1 growth/size/body region MP:0005378 9.23 BSCL2 F2 GARS1 KIF1B PES1 PLG

Drugs & Therapeutics for Thoracic Outlet Syndrome

Drugs for Thoracic Outlet Syndrome (from DrugBank, HMDB, Dgidb, PharmGKB, IUPHAR, NovoSeek, BitterDB):

(show all 13)
# Name Status Phase Clinical Trials Cas Number PubChem Id
1
Acetylcholine Approved, Investigational Phase 2 51-84-3 187
2 Neurotransmitter Agents Phase 2
3 abobotulinumtoxinA Phase 2
4 Cholinergic Agents Phase 2
5 Botulinum Toxins, Type A Phase 2
6 Botulinum Toxins Phase 2
7 incobotulinumtoxinA Phase 1
8
Sodium citrate Approved, Investigational 68-04-2
9
Ropivacaine Approved 84057-95-4 71273 175805
10
Citric acid Approved, Nutraceutical, Vet_approved 77-92-9 311
11 Anticoagulants
12 Pharmaceutical Solutions
13 Citrate

Interventional clinical trials:

(show all 13)
# Name Status NCT ID Phase Drugs
1 Treatment of Thoracic Outlet Syndrome With Botulinum Toxin Injection: A Double-Blind, Randomized Controlled Trial Completed NCT00444886 Phase 2 Botulinum Toxin Type A injection (BOTOX);Botulinum Toxin Type A injection (BOTOX)
2 Botulin Toxin Type A Injections for Thoracic Outlet Syndrome: A Double-Blind, Randomized Control Trial Unknown status NCT01405482 Phase 1 Botulinum Toxin Type A
3 Thoracic Outlet Syndrome: Case Reports and Analysis - Ultrasound Imaging and Pathomechanics of Brachial Plexus Compression Completed NCT01196637
4 The Effectiveness of Diagnosis and Treatment of Thoracic Outlet Syndrome Completed NCT01342068
5 Assessment of the Impact of Thoracic Outlet Syndromes on the Performance at Work Recruiting NCT03780647
6 Computational Fluid Dynamics Analysis for the Risk of Thoracic Outlet Syndrome in Sporty Subjects Recruiting NCT04428125
7 Application de l'oxymétrie Dynamique Pour le Diagnostic Des Syndromes de défilés Thoraco-brachiaux Systematic Transcutaneous Oxymetry Use in Thoracic Outlet Syndrom Recruiting NCT03355274
8 Evaluation Des Mesures Dopplers, Angiographiques, Radiographique Oximetriques, Plethysmographiques, Electromyographiques et Des Questionnaires Cliniques Des Patients adressés Pour Suspicion de Syndrome du défilé Thoraco-brachial Recruiting NCT04376177
9 Evaluation of the Muscular FORCE in the Upper Limbs of Patients Presenting a Thoracic Outlet Syndrome : Monocentric Case-control Study Recruiting NCT04145778
10 Surgical Thoracic Outlet Decompression Versus Conservative Approach for Patients With Neurogenic Thoracic Outlet Syndrome, a Randomized Controlled Trial Active, not recruiting NCT03748602
11 Neurogenic Thoracic Outlet Syndrome and Other Forms of Cervical Brachial Syndrome Treated With Plasma Concentrate Enriched for Alpha 2 Macroglobulin Active, not recruiting NCT04066933
12 Outpatient Office Based Endovascular Procedures Enrolling by invitation NCT04054440
13 The Use of Pectoral Nerve Block Type II in Patients Undergoing Trans-axillary Thoracic Outlet Decompression Not yet recruiting NCT04471545

Search NIH Clinical Center for Thoracic Outlet Syndrome

Cochrane evidence based reviews: thoracic outlet syndrome

Genetic Tests for Thoracic Outlet Syndrome

Anatomical Context for Thoracic Outlet Syndrome

MalaCards organs/tissues related to Thoracic Outlet Syndrome:

40
Spinal Cord, Heart, Bone, Lung, Bone Marrow, Lymph Node, Appendix

Publications for Thoracic Outlet Syndrome

Articles related to Thoracic Outlet Syndrome:

(show top 50) (show all 1805)
# Title Authors PMID Year
1
Evaluation and treatment of thoracic outlet syndrome during the global pandemic due to SARS-CoV-2 and COVID-19. 61 42
32497747 2020
2
Effects of Kinesio Taping on pain, paresthesia, functional status, and overall health status in patients with symptomatic thoracic outlet syndrome: A single-blind, randomized, placebo-controlled study. 61 42
32442118 2020
3
Traditional medicine treatment for thoracic outlet syndrome: A protocol for systematic review of randomized controlled trials. 61 42
32629739 2020
4
The thoracic outlet syndromes: Part 1. Overview of the thoracic outlet syndromes and review of true neurogenic thoracic outlet syndrome. 61 20
28006844 2017
5
The thoracic outlet syndromes: Part 2. The arterial, venous, neurovascular, and disputed thoracic outlet syndromes. 20
28006856 2017
6
Endoscopic Posterior Approach for Cervicothoracic and Upper Thoracic Foraminotomies: 2-Dimensional Operative Video. 61
33694363 2021
7
Thoracic outlet decompression for subclavian venous stenosis after ipsilateral hemodialysis access creation. 61
33676044 2021
8
Athletic Injuries of the Thoracic Cage. 61
33646909 2021
9
Thoracic outlet syndrome in a patient with SAPHO syndrome - A case report. 61
33667913 2021
10
Sport and Venous Thromboembolism—Site, Accompanying Features, Symptoms, and Diagnosis. 61
33558005 2021
11
Subperiosteal chondromyxoid fibroma: a rare case involving the humeral diaphysis. 61
32803376 2021
12
A review of upper extremity deep vein thrombosis. 61
33618595 2021
13
FETOS: A Self-Questionnaire for Functional Evaluation in Thoracic Outlet Syndrome. 61
33595940 2021
14
Late Venous Thoracic Outlet Syndrome After Anatomic Fixation of a Diaphyseal Clavicle Fracture: A Case Report. 61
33690240 2021
15
Thoracic Outlet Syndrome: A Narrative Review. 61
33804565 2021
16
A Multidisciplinary Approach to Neurogenic Thoracic Outlet Syndrome: Sinking Deeper or Stepping Out of a Chaotic Quagmire Onto Terra Firma? 61
33795198 2021
17
Thoracic Outlet Syndrome Is Typically Not an Urgent Condition. 61
33630561 2021
18
Feasibility and Outcomes of a Multidisciplinary Care Pathway for Neurogenic Thoracic Outlet Syndrome: A Prospective Observational Cohort Study. 61
33810976 2021
19
Chylothorax post transaxillary first rib resection for thoracic outlet syndrome. 61
33685908 2021
20
MEASUREMENT OF INTERSCALENE SPACE VOLUME IN DIAGNOSIS OF THORACIC OUTLET SYNDROME: A CADAVER STUDY. 61
33754653 2021
21
Performance in major league baseball pitchers after surgical treatment of thoracic outlet syndrome. 61
33472488 2021
22
Postoperative outcomes in thoracic outlet decompression for acute versus chronic venous thoracic outlet syndrome. 61
32464288 2021
23
Neurogenic Thoracic Outlet Syndrome with Supraclavicular Release: Long-Term Outcome without Rib Resection. 61
33807803 2021
24
Epidemiology of thoracic outlet syndrome. 61
33757638 2021
25
Anatomy and Embryology of the Thoracic Outlet. 61
33220766 2021
26
Surgical Technique: Minimally Invasive First-Rib Resection. 61
33220774 2021
27
Surgical Technique: Supraclavicular First Rib Resection. 61
33220773 2021
28
The role of ultrasound imaging in vascular compression syndromes. 61
33555480 2021
29
How Common Is Thoracic Outlet Syndrome? 61
33220767 2021
30
Evaluation and Management of Venous Thoracic Outlet Syndrome. 61
33220769 2021
31
Evaluation and Management of Arterial Thoracic Outlet Syndrome. 61
33220770 2021
32
Evaluation of Patients with Neurogenic Thoracic Outlet Syndrome. 61
33220771 2021
33
Physical Therapy Management of Neurogenic Thoracic Outlet Syndrome. 61
33220772 2021
34
Contemporary Management of Arterial Thoracic Outlet Syndrome. 61
33556514 2021
35
Development and Evolution of a Robotic Surgical Technique for the Treatment of Thoracic Outlet Syndrome. 61
33639235 2021
36
Response to "letter to editor: Symptoms and absence of symptoms while using a telephone: The paradox of thoracic outlet syndrome". 61
33032970 2021
37
Symptoms and absence of symptoms while using a telephone: The paradox of thoracic outlet syndrome. 61
33032971 2021
38
Imaging Assessment of Thoracic Outlet Syndrome. 61
33220768 2021
39
Contemporary Practices and Complications of Surgery for Thoracic Outlet Syndrome in the United States. 61
33340669 2021
40
Endoscopic-Assisted Transaxillary Approach for First Rib Resection in Thoracic Outlet Syndrome. 61
33615259 2021
41
Same Admission Hybrid Treatment of Primary Upper Extremity Deep Venous Thrombosis with Thrombolysis, Transaxillary Thoracic Outlet Decompression, and Immediate Endovascular Evaluation. 61
32795648 2021
42
Utility of the Pectoral Nerve Block (PECS II) for Analgesia Following Transaxillary First Rib Section. 61
33549776 2021
43
Rib Osteoblastoma as a Cause of Neurogenic Thoracic Outlet Syndrome: A Case Report. 61
33556044 2021
44
A novel technique for transaxillary resection of fully formed cervical ribs with long-term clinical outcomes. 61
32707395 2021
45
The use of ultrasound in the emergency department for the detection of thoracic outlet syndrome: A single case study. 61
33552230 2021
46
Reoperation for Persistent or Recurrent Neurogenic Thoracic Outlet Syndrome. 61
33220775 2021
47
Undiagnosed bilateral complete cervical rib with subclavian artery aneurysm presenting as acute ischaemic limb following high-altitude expedition. 61
33637509 2021
48
Pacemaker lead-induced venous thoracic outlet syndrome. 61
33526458 2021
49
Thoracic Outlet Syndrome Evaluation: Patience Is a Virtue. 61
33220776 2021
50
Challenges in the Evaluation and Management of Thoracic Outlet Syndrome. 61
33220777 2021

Variations for Thoracic Outlet Syndrome

Expression for Thoracic Outlet Syndrome

Search GEO for disease gene expression data for Thoracic Outlet Syndrome.

Pathways for Thoracic Outlet Syndrome

GO Terms for Thoracic Outlet Syndrome

Cellular components related to Thoracic Outlet Syndrome according to GeneCards Suite gene sharing:

# Name GO ID Score Top Affiliating Genes
1 blood microparticle GO:0072562 8.8 SERPINC1 PLG F2

Biological processes related to Thoracic Outlet Syndrome according to GeneCards Suite gene sharing:

# Name GO ID Score Top Affiliating Genes
1 cellular protein metabolic process GO:0044267 9.54 SERPINC1 PLG F2
2 blood coagulation GO:0007596 9.5 SERPINC1 PLG F2
3 fibrinolysis GO:0042730 9.26 PLG F2
4 regulation of blood coagulation GO:0030193 9.16 SERPINC1 F2
5 negative regulation of fibrinolysis GO:0051918 8.96 PLG F2
6 hemostasis GO:0007599 8.8 SERPINC1 PLG F2

Sources for Thoracic Outlet Syndrome

3 CDC
7 CNVD
9 Cosmic
10 dbSNP
11 DGIdb
17 EFO
18 ExPASy
19 FMA
20 GARD
28 GO
29 GTR
30 HMDB
31 HPO
32 ICD10
33 ICD10 via Orphanet
34 ICD9CM
35 IUPHAR
36 KEGG
37 LifeMap
39 LOVD
41 MedGen
44 MeSH
45 MESH via Orphanet
46 MGI
49 NCI
50 NCIt
51 NDF-RT
53 NINDS
54 Novoseek
56 OMIM via Orphanet
57 OMIM® (Updated 20-May-2021)
61 PubMed
63 QIAGEN
68 SNOMED-CT via HPO
69 Tocris
70 UMLS
71 UMLS via Orphanet
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