Practice A Patient’s Journey

Thoracic outlet syndrome

BMJ 2012; 345 doi: (Published 09 November 2012) Cite this as: BMJ 2012;345:e7373

Re: Thoracic outlet syndrome

Dr. Giele,

You mention that TOS can result from a variety of structural deviations that are not usually identifiable on MRI. Can TOS result from hypertonic soft tissue (e.g. the scalenes or pectoralis minor) impinging on neurovascular structures? And, if so, given equivocal MRI findings might it be best to first treat a patient with TOS conservatively (e.g. prescription for massage therapy of the accessory breathing muscles) before considering the more invasive option of surgery?

Thank you for your time and I look forward to your response.

Marco Masci

Competing interests: No competing interests

29 November 2012
Marco Masci
medical student
Weill-Cornell Medical College
445 E. 69th St, #804, NYC, NY 10021 USA