{"id":21214,"date":"2026-04-09T18:32:19","date_gmt":"2026-04-09T18:32:19","guid":{"rendered":"https:\/\/hlsllc.org\/tos\/?page_id=21214"},"modified":"2026-04-13T21:45:17","modified_gmt":"2026-04-13T21:45:17","slug":"diagnosis-of-arterial-thoracic-outlet-syndrome","status":"publish","type":"page","link":"https:\/\/hlsllc.org\/tos\/diagnosis-of-arterial-thoracic-outlet-syndrome\/","title":{"rendered":"Diagnosis of Arterial Thoracic Outlet Syndrome"},"content":{"rendered":"\t\t<div data-elementor-type=\"wp-page\" data-elementor-id=\"21214\" class=\"elementor elementor-21214\" data-elementor-post-type=\"page\">\n\t\t\t\t<div class=\"elementor-element elementor-element-23ae775 e-con-full e-flex e-con e-parent\" data-id=\"23ae775\" data-element_type=\"container\" data-e-type=\"container\" data-settings=\"{&quot;background_background&quot;:&quot;classic&quot;}\">\n\t\t\t\t<div class=\"elementor-element elementor-element-e17cf92 elementor-widget elementor-widget-heading\" data-id=\"e17cf92\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t\t<h2 class=\"elementor-heading-title elementor-size-default\">Diagnosis of Arterial Thoracic Outlet Syndrome\n<\/h2>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div class=\"elementor-element elementor-element-eace37f e-con-full e-flex e-con e-parent\" data-id=\"eace37f\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t<div class=\"elementor-element elementor-element-c764476 e-con-full e-flex e-con e-child\" data-id=\"c764476\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t\t\t<div class=\"elementor-element elementor-element-4781ff0 elementor-widget elementor-widget-heading\" data-id=\"4781ff0\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t\t<h2 class=\"elementor-heading-title elementor-size-default\">Symptoms of Venous TOS\n<\/h2>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div class=\"elementor-element elementor-element-ab1ef8b e-con-full e-flex e-con e-child\" data-id=\"ab1ef8b\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t\t\t<div class=\"elementor-element elementor-element-8e6faee elementor-widget-divider--view-line elementor-widget elementor-widget-divider\" data-id=\"8e6faee\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"divider.default\">\n\t\t\t\t\t\t\t<div class=\"elementor-divider\">\n\t\t\t<span class=\"elementor-divider-separator\">\n\t\t\t\t\t\t<\/span>\n\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div class=\"elementor-element elementor-element-65413b1 e-con-full e-flex e-con e-parent\" data-id=\"65413b1\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t<div class=\"elementor-element elementor-element-a57baa8 e-con-full e-flex e-con e-child\" data-id=\"a57baa8\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t\t\t<div class=\"elementor-element elementor-element-89d5603 elementor-widget elementor-widget-text-editor\" data-id=\"89d5603\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t\t\t\t\t\t<div class=\"fusion-title title fusion-title-text fusion-title-size-paragraph\"><div class=\"fusion-text\"><div class=\"fusion-li-item-content\"><div class=\"fusion-text fusion-text-1\"><div class=\"fusion-text fusion-text-1\"><p>Arterial TOS is rare and quite serious. The symptoms of arterial TOS are often sudden and severe. These symptoms are caused by sudden occlusion of one or more arteries in the affected arm. Arterial occlusion blocks blood flow to the arm, which may lead to severe complications if not diagnosed and treated promptly.<\/p><\/div><\/div><\/div><\/div><\/div>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-51fa62b elementor-widget elementor-widget-image\" data-id=\"51fa62b\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"image.default\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<img fetchpriority=\"high\" decoding=\"async\" width=\"600\" height=\"400\" src=\"https:\/\/hlsllc.org\/tos\/wp-content\/uploads\/2026\/04\/Female-Red-Hair-Pain-Hands-Crop-600.jpg\" class=\"attachment-large size-large wp-image-21225\" alt=\"\" \/>\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-b8a43fd elementor-widget elementor-widget-heading\" data-id=\"b8a43fd\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t\t<h2 class=\"elementor-heading-title elementor-size-default\">Symptoms of Arterial TOS\n<\/h2>\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-bc9a9c5 elementor-widget elementor-widget-text-editor\" data-id=\"bc9a9c5\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t\t\t\t\t\t<div class=\"fusion-title title fusion-title-text fusion-title-size-paragraph\"><div class=\"fusion-text\"><div class=\"fusion-li-item-content\"><div class=\"fusion-text fusion-text-1\"><div class=\"fusion-text fusion-text-2\"><p>Patients with arterial TOS may present with acute arterial occlusion, local symptoms, intermittent arterial insufficiency, or chronic arterial insufficiency.<\/p><p>Patients with acute arterial occlusion may experience one or more of the\u00a0<strong>5 P\u2019s<\/strong>:<\/p><ul><li>Pain<\/li><li>Pallor<\/li><li>Paresthesias<\/li><li>Pulselessness<\/li><li>Paralysis<\/li><\/ul><p>Patients with these symptoms should seek immediate medical attention.<\/p><p>Local symptoms may include an aneurysm or a cervical rib. A patient may notice a cervical rib as a chronic hard lump at the base of their neck. A patient may feel a painless, pulsatile mass at the base of the neck. This pulsatile mass may represent a normal subclavian artery passing over a cervical rib, or a subclavian artery aneurysm.<\/p><p>Intermittent compression of the\u00a0subclavian artery causes symptoms only in specific arm positions; in other words, symptoms only occur in those arm positions where extrinsic structures compress the artery. Some patients notice their arm \u201cgoing to sleep\u201d in certain arm positions, or when they wake up from sleep.<\/p><p>Chronic or intermittent compression of the artery may cause scar or stenosis of the artery. As a result, chronically limited blood flow could cause chronic arm fatigue. Under those circumstances of chronically limited blood flow, the patient would experience\u00a0<strong>claudication<\/strong>.<\/p><\/div><\/div><\/div><\/div><\/div>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-d4189a0 elementor-icon-list--layout-traditional elementor-list-item-link-full_width elementor-widget elementor-widget-icon-list\" data-id=\"d4189a0\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"icon-list.default\">\n\t\t\t\t\t\t\t<ul class=\"elementor-icon-list-items\">\n\t\t\t\t\t\t\t<li class=\"elementor-icon-list-item\">\n\t\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-icon-list-icon\">\n\t\t\t\t\t\t\t<svg aria-hidden=\"true\" class=\"e-font-icon-svg e-fas-chevron-right\" viewBox=\"0 0 320 512\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path d=\"M285.476 272.971L91.132 467.314c-9.373 9.373-24.569 9.373-33.941 0l-22.667-22.667c-9.357-9.357-9.375-24.522-.04-33.901L188.505 256 34.484 101.255c-9.335-9.379-9.317-24.544.04-33.901l22.667-22.667c9.373-9.373 24.569-9.373 33.941 0L285.475 239.03c9.373 9.372 9.373 24.568.001 33.941z\"><\/path><\/svg>\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-icon-list-text\">Swelling of the arm<\/span>\n\t\t\t\t\t\t\t\t\t<\/li>\n\t\t\t\t\t\t\t\t<li class=\"elementor-icon-list-item\">\n\t\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-icon-list-icon\">\n\t\t\t\t\t\t\t<svg aria-hidden=\"true\" class=\"e-font-icon-svg e-fas-chevron-right\" viewBox=\"0 0 320 512\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path d=\"M285.476 272.971L91.132 467.314c-9.373 9.373-24.569 9.373-33.941 0l-22.667-22.667c-9.357-9.357-9.375-24.522-.04-33.901L188.505 256 34.484 101.255c-9.335-9.379-9.317-24.544.04-33.901l22.667-22.667c9.373-9.373 24.569-9.373 33.941 0L285.475 239.03c9.373 9.372 9.373 24.568.001 33.941z\"><\/path><\/svg>\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-icon-list-text\">Asymmetric size of the two arms<\/span>\n\t\t\t\t\t\t\t\t\t<\/li>\n\t\t\t\t\t\t\t\t<li class=\"elementor-icon-list-item\">\n\t\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-icon-list-icon\">\n\t\t\t\t\t\t\t<svg aria-hidden=\"true\" class=\"e-font-icon-svg e-fas-chevron-right\" viewBox=\"0 0 320 512\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path d=\"M285.476 272.971L91.132 467.314c-9.373 9.373-24.569 9.373-33.941 0l-22.667-22.667c-9.357-9.357-9.375-24.522-.04-33.901L188.505 256 34.484 101.255c-9.335-9.379-9.317-24.544.04-33.901l22.667-22.667c9.373-9.373 24.569-9.373 33.941 0L285.475 239.03c9.373 9.372 9.373 24.568.001 33.941z\"><\/path><\/svg>\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-icon-list-text\">Tense skin, with loss of usual skin folds<\/span>\n\t\t\t\t\t\t\t\t\t<\/li>\n\t\t\t\t\t\t\t\t<li class=\"elementor-icon-list-item\">\n\t\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-icon-list-icon\">\n\t\t\t\t\t\t\t<svg aria-hidden=\"true\" class=\"e-font-icon-svg e-fas-chevron-right\" viewBox=\"0 0 320 512\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path d=\"M285.476 272.971L91.132 467.314c-9.373 9.373-24.569 9.373-33.941 0l-22.667-22.667c-9.357-9.357-9.375-24.522-.04-33.901L188.505 256 34.484 101.255c-9.335-9.379-9.317-24.544.04-33.901l22.667-22.667c9.373-9.373 24.569-9.373 33.941 0L285.475 239.03c9.373 9.372 9.373 24.568.001 33.941z\"><\/path><\/svg>\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-icon-list-text\">Cyanosis, a blue or purple skin color<\/span>\n\t\t\t\t\t\t\t\t\t<\/li>\n\t\t\t\t\t\t\t\t<li class=\"elementor-icon-list-item\">\n\t\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-icon-list-icon\">\n\t\t\t\t\t\t\t<svg aria-hidden=\"true\" class=\"e-font-icon-svg e-fas-chevron-right\" viewBox=\"0 0 320 512\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path d=\"M285.476 272.971L91.132 467.314c-9.373 9.373-24.569 9.373-33.941 0l-22.667-22.667c-9.357-9.357-9.375-24.522-.04-33.901L188.505 256 34.484 101.255c-9.335-9.379-9.317-24.544.04-33.901l22.667-22.667c9.373-9.373 24.569-9.373 33.941 0L285.475 239.03c9.373 9.372 9.373 24.568.001 33.941z\"><\/path><\/svg>\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-icon-list-text\">Collateral veins; unusually prominent veins just under the skin of the shoulder or chest<\/span>\n\t\t\t\t\t\t\t\t\t<\/li>\n\t\t\t\t\t\t\t\t<li class=\"elementor-icon-list-item\">\n\t\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-icon-list-icon\">\n\t\t\t\t\t\t\t<svg aria-hidden=\"true\" class=\"e-font-icon-svg e-fas-chevron-right\" viewBox=\"0 0 320 512\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path d=\"M285.476 272.971L91.132 467.314c-9.373 9.373-24.569 9.373-33.941 0l-22.667-22.667c-9.357-9.357-9.375-24.522-.04-33.901L188.505 256 34.484 101.255c-9.335-9.379-9.317-24.544.04-33.901l22.667-22.667c9.373-9.373 24.569-9.373 33.941 0L285.475 239.03c9.373 9.372 9.373 24.568.001 33.941z\"><\/path><\/svg>\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-icon-list-text\">Increased venous angle<\/span>\n\t\t\t\t\t\t\t\t\t<\/li>\n\t\t\t\t\t\t\t\t<li class=\"elementor-icon-list-item\">\n\t\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-icon-list-icon\">\n\t\t\t\t\t\t\t<svg aria-hidden=\"true\" class=\"e-font-icon-svg e-fas-chevron-right\" viewBox=\"0 0 320 512\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path d=\"M285.476 272.971L91.132 467.314c-9.373 9.373-24.569 9.373-33.941 0l-22.667-22.667c-9.357-9.357-9.375-24.522-.04-33.901L188.505 256 34.484 101.255c-9.335-9.379-9.317-24.544.04-33.901l22.667-22.667c9.373-9.373 24.569-9.373 33.941 0L285.475 239.03c9.373 9.372 9.373 24.568.001 33.941z\"><\/path><\/svg>\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-icon-list-text\">Thickened subclavian vein in the underarm<\/span>\n\t\t\t\t\t\t\t\t\t<\/li>\n\t\t\t\t\t\t<\/ul>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-6ed4a9e elementor-widget-divider--view-line elementor-widget elementor-widget-divider\" data-id=\"6ed4a9e\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"divider.default\">\n\t\t\t\t\t\t\t<div class=\"elementor-divider\">\n\t\t\t<span class=\"elementor-divider-separator\">\n\t\t\t\t\t\t<\/span>\n\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div class=\"elementor-element elementor-element-460dbff e-con-full e-flex e-con e-child\" data-id=\"460dbff\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div class=\"elementor-element elementor-element-a06f93c e-con-full e-flex e-con e-parent\" data-id=\"a06f93c\" data-element_type=\"container\" data-e-type=\"container\" data-settings=\"{&quot;background_background&quot;:&quot;classic&quot;}\">\n\t\t\t\t<div class=\"elementor-element elementor-element-d1b7c9d elementor-widget elementor-widget-heading\" data-id=\"d1b7c9d\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t\t<h2 class=\"elementor-heading-title elementor-size-default\">Claudication is a symptom complex resulting from narrowing of a major artery, usually to an arm or a leg. Symptoms of claudication usually progress over time.\n<\/h2>\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-d070a7d elementor-icon-list--layout-traditional elementor-list-item-link-full_width elementor-widget elementor-widget-icon-list\" data-id=\"d070a7d\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"icon-list.default\">\n\t\t\t\t\t\t\t<ul class=\"elementor-icon-list-items\">\n\t\t\t\t\t\t\t<li class=\"elementor-icon-list-item\">\n\t\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-icon-list-icon\">\n\t\t\t\t\t\t\t<svg aria-hidden=\"true\" class=\"e-font-icon-svg e-fas-chevron-right\" viewBox=\"0 0 320 512\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path d=\"M285.476 272.971L91.132 467.314c-9.373 9.373-24.569 9.373-33.941 0l-22.667-22.667c-9.357-9.357-9.375-24.522-.04-33.901L188.505 256 34.484 101.255c-9.335-9.379-9.317-24.544.04-33.901l22.667-22.667c9.373-9.373 24.569-9.373 33.941 0L285.475 239.03c9.373 9.372 9.373 24.568.001 33.941z\"><\/path><\/svg>\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-icon-list-text\">Pain during exertion: A patient has adequate blood flow at rest, but arterial stenosis or compression limits the increased flow required during significant exertion. Thus, the patient notes symptoms only during exertion. Pain during significant exertion may therefore be the first sign of arterial stenosis or compression.<\/span>\n\t\t\t\t\t\t\t\t\t<\/li>\n\t\t\t\t\t\t\t\t<li class=\"elementor-icon-list-item\">\n\t\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-icon-list-icon\">\n\t\t\t\t\t\t\t<svg aria-hidden=\"true\" class=\"e-font-icon-svg e-fas-chevron-right\" viewBox=\"0 0 320 512\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path d=\"M285.476 272.971L91.132 467.314c-9.373 9.373-24.569 9.373-33.941 0l-22.667-22.667c-9.357-9.357-9.375-24.522-.04-33.901L188.505 256 34.484 101.255c-9.335-9.379-9.317-24.544.04-33.901l22.667-22.667c9.373-9.373 24.569-9.373 33.941 0L285.475 239.03c9.373 9.372 9.373 24.568.001 33.941z\"><\/path><\/svg>\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-icon-list-text\">Intermittent pain: Progression of  the degree of arterial stenosis or compression causes greater limitation of blood flow. The patient experiences pain with only mild exertion.<\/span>\n\t\t\t\t\t\t\t\t\t<\/li>\n\t\t\t\t\t\t\t\t<li class=\"elementor-icon-list-item\">\n\t\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-icon-list-icon\">\n\t\t\t\t\t\t\t<svg aria-hidden=\"true\" class=\"e-font-icon-svg e-fas-chevron-right\" viewBox=\"0 0 320 512\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path d=\"M285.476 272.971L91.132 467.314c-9.373 9.373-24.569 9.373-33.941 0l-22.667-22.667c-9.357-9.357-9.375-24.522-.04-33.901L188.505 256 34.484 101.255c-9.335-9.379-9.317-24.544.04-33.901l22.667-22.667c9.373-9.373 24.569-9.373 33.941 0L285.475 239.03c9.373 9.372 9.373 24.568.001 33.941z\"><\/path><\/svg>\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-icon-list-text\">Pain at rest: When arterial stenosis or compression becomes severe enough, limitation of blood flow occurs even at rest. Thus, the patient notes almost constant pain.<\/span>\n\t\t\t\t\t\t\t\t\t<\/li>\n\t\t\t\t\t\t\t\t<li class=\"elementor-icon-list-item\">\n\t\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-icon-list-icon\">\n\t\t\t\t\t\t\t<svg aria-hidden=\"true\" class=\"e-font-icon-svg e-fas-chevron-right\" viewBox=\"0 0 320 512\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path d=\"M285.476 272.971L91.132 467.314c-9.373 9.373-24.569 9.373-33.941 0l-22.667-22.667c-9.357-9.357-9.375-24.522-.04-33.901L188.505 256 34.484 101.255c-9.335-9.379-9.317-24.544.04-33.901l22.667-22.667c9.373-9.373 24.569-9.373 33.941 0L285.475 239.03c9.373 9.372 9.373 24.568.001 33.941z\"><\/path><\/svg>\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-icon-list-text\">Skin changes: Chronic severe limitation of arterial blood flow causes trophic changes to the skin of the affected area. The skin in the affected area becomes smooth, shiny and hairless. Small skin ulcers or areas of discoloration may form in the affected arm or fingers. The skin may feel cold to the touch.<\/span>\n\t\t\t\t\t\t\t\t\t<\/li>\n\t\t\t\t\t\t<\/ul>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div class=\"elementor-element elementor-element-a5fc866 e-con-full e-flex e-con e-parent\" data-id=\"a5fc866\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t<div class=\"elementor-element elementor-element-048a31a e-con-full e-flex e-con e-child\" data-id=\"048a31a\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t\t\t<div class=\"elementor-element elementor-element-649a1f0 elementor-widget elementor-widget-heading\" data-id=\"649a1f0\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t\t<h2 class=\"elementor-heading-title elementor-size-default\">Clinical Diagnosis of Arterial TOS\n<\/h2>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div class=\"elementor-element elementor-element-df428cf e-con-full e-flex e-con e-child\" data-id=\"df428cf\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t\t\t<div class=\"elementor-element elementor-element-0dab9f4 elementor-widget-divider--view-line elementor-widget elementor-widget-divider\" data-id=\"0dab9f4\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"divider.default\">\n\t\t\t\t\t\t\t<div class=\"elementor-divider\">\n\t\t\t<span class=\"elementor-divider-separator\">\n\t\t\t\t\t\t<\/span>\n\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div class=\"elementor-element elementor-element-8cca5d8 e-con-full e-flex e-con e-parent\" data-id=\"8cca5d8\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t<div class=\"elementor-element elementor-element-9ece56c e-con-full e-flex e-con e-child\" data-id=\"9ece56c\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t\t\t<div class=\"elementor-element elementor-element-d515fa7 elementor-widget elementor-widget-text-editor\" data-id=\"d515fa7\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t\t\t\t\t\t<div class=\"fusion-title title fusion-title-text fusion-title-size-paragraph\"><div class=\"fusion-text\"><div class=\"fusion-li-item-content\"><div class=\"fusion-text fusion-text-1\"><div class=\"fusion-text fusion-text-1\"><div class=\"fusion-text fusion-text-4\"><p>Arterial TOS is rare, but may cause severe complications. The presentation of arterial TOS is dramatic and usually quite obvious. Doctors make the clinical diagnosis of arterial TOS promptly and accurately in most cases. Primary treatment of the arterial blood clot should begin almost immediately.<\/p><\/div><\/div><\/div><\/div><\/div><\/div>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-85ee325 elementor-widget elementor-widget-image\" data-id=\"85ee325\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"image.default\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<img decoding=\"async\" width=\"600\" height=\"400\" src=\"https:\/\/hlsllc.org\/tos\/wp-content\/uploads\/2026\/04\/Woman-African-Face-Pain-Hair-Hands-Cropped-1.jpg\" class=\"attachment-large size-large wp-image-21239\" alt=\"\" \/>\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-2d1c66f elementor-widget-divider--view-line elementor-widget elementor-widget-divider\" data-id=\"2d1c66f\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"divider.default\">\n\t\t\t\t\t\t\t<div class=\"elementor-divider\">\n\t\t\t<span class=\"elementor-divider-separator\">\n\t\t\t\t\t\t<\/span>\n\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-427dc2b elementor-widget elementor-widget-heading\" data-id=\"427dc2b\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t\t<h2 class=\"elementor-heading-title elementor-size-default\">Physical Examination of Arterial TOS\n<\/h2>\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-dc9c51b elementor-widget elementor-widget-text-editor\" data-id=\"dc9c51b\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t\t\t\t\t\tArterial TOS presents in a dramatic fashion, with potentially severe complications. Thus, a doctor would promptly begin with a physical examination focused on finding one or more of 4 pathologic processes.\n\n\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-7998d5c elementor-icon-list--layout-traditional elementor-list-item-link-full_width elementor-widget elementor-widget-icon-list\" data-id=\"7998d5c\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"icon-list.default\">\n\t\t\t\t\t\t\t<ul class=\"elementor-icon-list-items\">\n\t\t\t\t\t\t\t<li class=\"elementor-icon-list-item\">\n\t\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-icon-list-icon\">\n\t\t\t\t\t\t\t<svg aria-hidden=\"true\" class=\"e-font-icon-svg e-fas-chevron-right\" viewBox=\"0 0 320 512\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path d=\"M285.476 272.971L91.132 467.314c-9.373 9.373-24.569 9.373-33.941 0l-22.667-22.667c-9.357-9.357-9.375-24.522-.04-33.901L188.505 256 34.484 101.255c-9.335-9.379-9.317-24.544.04-33.901l22.667-22.667c9.373-9.373 24.569-9.373 33.941 0L285.475 239.03c9.373 9.372 9.373 24.568.001 33.941z\"><\/path><\/svg>\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-icon-list-text\">Acute arterial insufficiency- a blood clot causes critical loss of blood flow in a large artery<\/span>\n\t\t\t\t\t\t\t\t\t<\/li>\n\t\t\t\t\t\t\t\t<li class=\"elementor-icon-list-item\">\n\t\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-icon-list-icon\">\n\t\t\t\t\t\t\t<svg aria-hidden=\"true\" class=\"e-font-icon-svg e-fas-chevron-right\" viewBox=\"0 0 320 512\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path d=\"M285.476 272.971L91.132 467.314c-9.373 9.373-24.569 9.373-33.941 0l-22.667-22.667c-9.357-9.357-9.375-24.522-.04-33.901L188.505 256 34.484 101.255c-9.335-9.379-9.317-24.544.04-33.901l22.667-22.667c9.373-9.373 24.569-9.373 33.941 0L285.475 239.03c9.373 9.372 9.373 24.568.001 33.941z\"><\/path><\/svg>\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-icon-list-text\">Emboli-blood clot fragments that break off and travel to smaller arteries<\/span>\n\t\t\t\t\t\t\t\t\t<\/li>\n\t\t\t\t\t\t\t\t<li class=\"elementor-icon-list-item\">\n\t\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-icon-list-icon\">\n\t\t\t\t\t\t\t<svg aria-hidden=\"true\" class=\"e-font-icon-svg e-fas-chevron-right\" viewBox=\"0 0 320 512\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path d=\"M285.476 272.971L91.132 467.314c-9.373 9.373-24.569 9.373-33.941 0l-22.667-22.667c-9.357-9.357-9.375-24.522-.04-33.901L188.505 256 34.484 101.255c-9.335-9.379-9.317-24.544.04-33.901l22.667-22.667c9.373-9.373 24.569-9.373 33.941 0L285.475 239.03c9.373 9.372 9.373 24.568.001 33.941z\"><\/path><\/svg>\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-icon-list-text\">Aneurysm-focal dilation and ballooning of a damaged artery<\/span>\n\t\t\t\t\t\t\t\t\t<\/li>\n\t\t\t\t\t\t\t\t<li class=\"elementor-icon-list-item\">\n\t\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-icon-list-icon\">\n\t\t\t\t\t\t\t<svg aria-hidden=\"true\" class=\"e-font-icon-svg e-fas-chevron-right\" viewBox=\"0 0 320 512\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path d=\"M285.476 272.971L91.132 467.314c-9.373 9.373-24.569 9.373-33.941 0l-22.667-22.667c-9.357-9.357-9.375-24.522-.04-33.901L188.505 256 34.484 101.255c-9.335-9.379-9.317-24.544.04-33.901l22.667-22.667c9.373-9.373 24.569-9.373 33.941 0L285.475 239.03c9.373 9.372 9.373 24.568.001 33.941z\"><\/path><\/svg>\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-icon-list-text\">Chronic arterial insufficiency-chronically limited arterial blood flow caused by stenosis or chronic clot<\/span>\n\t\t\t\t\t\t\t\t\t<\/li>\n\t\t\t\t\t\t<\/ul>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-c3f3f0e elementor-widget elementor-widget-text-editor\" data-id=\"c3f3f0e\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t\t\t\t\t\t<div class=\"fusion-text fusion-text-6\"><p>Acute arterial occlusion puts the patient at risk of permanent tissue loss and loss of function. Because of this risk, a physician will always look for signs of acute arterial insufficiency, including the 5 Ps:<\/p><\/div>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-4c722bc elementor-icon-list--layout-traditional elementor-list-item-link-full_width elementor-widget elementor-widget-icon-list\" data-id=\"4c722bc\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"icon-list.default\">\n\t\t\t\t\t\t\t<ul class=\"elementor-icon-list-items\">\n\t\t\t\t\t\t\t<li class=\"elementor-icon-list-item\">\n\t\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-icon-list-icon\">\n\t\t\t\t\t\t\t<svg aria-hidden=\"true\" class=\"e-font-icon-svg e-fas-chevron-right\" viewBox=\"0 0 320 512\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path d=\"M285.476 272.971L91.132 467.314c-9.373 9.373-24.569 9.373-33.941 0l-22.667-22.667c-9.357-9.357-9.375-24.522-.04-33.901L188.505 256 34.484 101.255c-9.335-9.379-9.317-24.544.04-33.901l22.667-22.667c9.373-9.373 24.569-9.373 33.941 0L285.475 239.03c9.373 9.372 9.373 24.568.001 33.941z\"><\/path><\/svg>\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-icon-list-text\">Pain<\/span>\n\t\t\t\t\t\t\t\t\t<\/li>\n\t\t\t\t\t\t\t\t<li class=\"elementor-icon-list-item\">\n\t\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-icon-list-icon\">\n\t\t\t\t\t\t\t<svg aria-hidden=\"true\" class=\"e-font-icon-svg e-fas-chevron-right\" viewBox=\"0 0 320 512\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path d=\"M285.476 272.971L91.132 467.314c-9.373 9.373-24.569 9.373-33.941 0l-22.667-22.667c-9.357-9.357-9.375-24.522-.04-33.901L188.505 256 34.484 101.255c-9.335-9.379-9.317-24.544.04-33.901l22.667-22.667c9.373-9.373 24.569-9.373 33.941 0L285.475 239.03c9.373 9.372 9.373 24.568.001 33.941z\"><\/path><\/svg>\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-icon-list-text\">Pallor-pale or white color<\/span>\n\t\t\t\t\t\t\t\t\t<\/li>\n\t\t\t\t\t\t\t\t<li class=\"elementor-icon-list-item\">\n\t\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-icon-list-icon\">\n\t\t\t\t\t\t\t<svg aria-hidden=\"true\" class=\"e-font-icon-svg e-fas-chevron-right\" viewBox=\"0 0 320 512\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path d=\"M285.476 272.971L91.132 467.314c-9.373 9.373-24.569 9.373-33.941 0l-22.667-22.667c-9.357-9.357-9.375-24.522-.04-33.901L188.505 256 34.484 101.255c-9.335-9.379-9.317-24.544.04-33.901l22.667-22.667c9.373-9.373 24.569-9.373 33.941 0L285.475 239.03c9.373 9.372 9.373 24.568.001 33.941z\"><\/path><\/svg>\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-icon-list-text\">Paresthesias-tingling<\/span>\n\t\t\t\t\t\t\t\t\t<\/li>\n\t\t\t\t\t\t\t\t<li class=\"elementor-icon-list-item\">\n\t\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-icon-list-icon\">\n\t\t\t\t\t\t\t<svg aria-hidden=\"true\" class=\"e-font-icon-svg e-fas-chevron-right\" viewBox=\"0 0 320 512\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path d=\"M285.476 272.971L91.132 467.314c-9.373 9.373-24.569 9.373-33.941 0l-22.667-22.667c-9.357-9.357-9.375-24.522-.04-33.901L188.505 256 34.484 101.255c-9.335-9.379-9.317-24.544.04-33.901l22.667-22.667c9.373-9.373 24.569-9.373 33.941 0L285.475 239.03c9.373 9.372 9.373 24.568.001 33.941z\"><\/path><\/svg>\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-icon-list-text\">Pulselesness-loss of expected arterial pulse<\/span>\n\t\t\t\t\t\t\t\t\t<\/li>\n\t\t\t\t\t\t\t\t<li class=\"elementor-icon-list-item\">\n\t\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-icon-list-icon\">\n\t\t\t\t\t\t\t<svg aria-hidden=\"true\" class=\"e-font-icon-svg e-fas-chevron-right\" viewBox=\"0 0 320 512\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path d=\"M285.476 272.971L91.132 467.314c-9.373 9.373-24.569 9.373-33.941 0l-22.667-22.667c-9.357-9.357-9.375-24.522-.04-33.901L188.505 256 34.484 101.255c-9.335-9.379-9.317-24.544.04-33.901l22.667-22.667c9.373-9.373 24.569-9.373 33.941 0L285.475 239.03c9.373 9.372 9.373 24.568.001 33.941z\"><\/path><\/svg>\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-icon-list-text\">Paralysis-loss of strength or function<\/span>\n\t\t\t\t\t\t\t\t\t<\/li>\n\t\t\t\t\t\t<\/ul>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-e44f099 elementor-widget elementor-widget-text-editor\" data-id=\"e44f099\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t\t\t\t\t\t<div class=\"fusion-text fusion-text-6\"><div class=\"fusion-text fusion-text-7\"><p>After this, the physician will look for signs of\u00a0arterial emboli. These signs include skin ulcerations and discoloration, and\u00a0<strong>splinter hemorrhages<\/strong>. Splinter hemorrhages are tiny blood clot fragments (<strong>emboli<\/strong>) that travel from the damaged artery to small arteries in the fingers. These emboli cause tiny hemorrhages where they lodge, which appear as tiny black spots. Thus, splinter hemorrhages are a sign of a proximal blood clot, usually in the arteries or heart. \u00a0The presence of splinter hemorrhages necessitates a search for the source of emboli.<\/p><\/div><div class=\"fusion-text fusion-text-8\"><p>Your doctor will also examine the thoracic outlet on each side for the presence of a pulsatile mass. This mass may prove a subclavian artery aneurysm, or a normal subclavian artery passing over a cervical rib. With or without an aneurysm, your doctor may hear a\u00a0<i>bruit<\/i>\u00a0in the thoracic outlet with her stethoscope. A bruit is a swooshing sound caused by turbulent arterial blood flow. Narrowing of an artery may cause blood pressure in the two arms to be different.\u00a0Finally, your physician will look for signs of chronic arterial insufficiency, including chronic skin changes.<\/p><\/div><\/div>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-d6a68e8 elementor-widget elementor-widget-heading\" data-id=\"d6a68e8\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t\t<h2 class=\"elementor-heading-title elementor-size-default\">Imaging Tests\n<\/h2>\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-6a17ba3 elementor-widget elementor-widget-text-editor\" data-id=\"6a17ba3\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t\t\t\t\t\t<div class=\"fusion-text fusion-text-6\"><div class=\"fusion-text fusion-text-7\"><div class=\"fusion-text fusion-text-8\"><p><a href=\"https:\/\/www.tosmri.com\/why-do-you-need-an-imaging-test-for-tos-unveiling-neurogenic-tos-diagnosis\/\" data-wpil-monitor-id=\"18\">Imaging tests<\/a>\u00a0are incredibly valuable tools in modern medicine. They are particularly valuable for a disease in a complex anatomic area like the thoracic outlet. In patients with\u00a0arterial TOS,\u00a0<a title=\"Thoracic Outlet Syndrome MRI: Diagnosis and Treatment Options\" href=\"https:\/\/www.tosmri.com\/thoracic-outlet-syndrome-mri-diagnosis-and-treatment-options\/\" data-wpil-monitor-id=\"220\">imaging tests confirm the doctor\u2019s clinical diagnosis<\/a>\u00a0in several important ways. Read more about the value of imaging tests here.<\/p><\/div><\/div><\/div>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-9582311 e-n-tabs-mobile elementor-widget elementor-widget-n-tabs\" data-id=\"9582311\" data-element_type=\"widget\" data-e-type=\"widget\" data-settings=\"{&quot;horizontal_scroll&quot;:&quot;disable&quot;}\" data-widget_type=\"nested-tabs.default\">\n\t\t\t\t\t\t\t<div class=\"e-n-tabs\" data-widget-number=\"156771089\" aria-label=\"Tabs. Open items with Enter or Space, close with Escape and navigate using the Arrow keys.\">\n\t\t\t<div class=\"e-n-tabs-heading\" role=\"tablist\">\n\t\t\t\t\t<button id=\"e-n-tab-title-1567710891\" data-tab-title-id=\"e-n-tab-title-1567710891\" class=\"e-n-tab-title\" aria-selected=\"true\" data-tab-index=\"1\" role=\"tab\" tabindex=\"0\" aria-controls=\"e-n-tab-content-1567710891\" style=\"--n-tabs-title-order: 1;\">\n\t\t\t\t\t\t<span class=\"e-n-tab-title-text\">\n\t\t\t\tX-rays\t\t\t<\/span>\n\t\t<\/button>\n\t\t\t\t<button id=\"e-n-tab-title-1567710892\" data-tab-title-id=\"e-n-tab-title-1567710892\" class=\"e-n-tab-title\" aria-selected=\"false\" data-tab-index=\"2\" role=\"tab\" tabindex=\"-1\" aria-controls=\"e-n-tab-content-1567710892\" style=\"--n-tabs-title-order: 2;\">\n\t\t\t\t\t\t<span class=\"e-n-tab-title-text\">\n\t\t\t\tAngiography\t\t\t<\/span>\n\t\t<\/button>\n\t\t\t\t<button id=\"e-n-tab-title-1567710893\" data-tab-title-id=\"e-n-tab-title-1567710893\" class=\"e-n-tab-title\" aria-selected=\"false\" data-tab-index=\"3\" role=\"tab\" tabindex=\"-1\" aria-controls=\"e-n-tab-content-1567710893\" style=\"--n-tabs-title-order: 3;\">\n\t\t\t\t\t\t<span class=\"e-n-tab-title-text\">\n\t\t\t\tUltrasound \t\t\t<\/span>\n\t\t<\/button>\n\t\t\t\t<button id=\"e-n-tab-title-1567710894\" data-tab-title-id=\"e-n-tab-title-1567710894\" class=\"e-n-tab-title\" aria-selected=\"false\" data-tab-index=\"4\" role=\"tab\" tabindex=\"-1\" aria-controls=\"e-n-tab-content-1567710894\" style=\"--n-tabs-title-order: 4;\">\n\t\t\t\t\t\t<span class=\"e-n-tab-title-text\">\n\t\t\t\tCTA\t\t\t<\/span>\n\t\t<\/button>\n\t\t\t\t<button id=\"e-n-tab-title-1567710895\" data-tab-title-id=\"e-n-tab-title-1567710895\" class=\"e-n-tab-title\" aria-selected=\"false\" data-tab-index=\"5\" role=\"tab\" tabindex=\"-1\" aria-controls=\"e-n-tab-content-1567710895\" style=\"--n-tabs-title-order: 5;\">\n\t\t\t\t\t\t<span class=\"e-n-tab-title-text\">\n\t\t\t\tMRA\t\t\t<\/span>\n\t\t<\/button>\n\t\t\t\t\t<\/div>\n\t\t\t<div class=\"e-n-tabs-content\">\n\t\t\t\t<div id=\"e-n-tab-content-1567710891\" role=\"tabpanel\" aria-labelledby=\"e-n-tab-title-1567710891\" data-tab-index=\"1\" style=\"--n-tabs-title-order: 1;\" class=\"e-active elementor-element elementor-element-2f62722 e-con-full e-flex e-con e-child\" data-id=\"2f62722\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t\t\t<div class=\"elementor-element elementor-element-3118999 elementor-position-left elementor-vertical-align-top elementor-widget elementor-widget-image-box\" data-id=\"3118999\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"image-box.default\">\n\t\t\t\t\t<div class=\"elementor-image-box-wrapper\"><figure class=\"elementor-image-box-img\"><img decoding=\"async\" width=\"200\" height=\"200\" src=\"https:\/\/hlsllc.org\/tos\/wp-content\/uploads\/2026\/04\/Thumbnail-CR-C-spine-Rt-C7-Elongation-and-Lt-Cervical-Rib.jpg\" class=\"attachment-full size-full wp-image-21240\" alt=\"\" \/><\/figure><div class=\"elementor-image-box-content\"><p class=\"elementor-image-box-description\">X-rays show excellent bone detail, but do not show soft tissue detail, and are limited to two dimensions. X-rays do not show arteries or veins. About 1% of the population has cervical ribs, but most of these people do not have arterial TOS. Even in patients with cervical ribs and arterial TOS, they have had cervical ribs their entire life, and only developed arterial TOS when they become symptomatic. X-rays thus have quite limited value in diagnosing arterial TOS and in planning treatment.<\/p><\/div><\/div>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div id=\"e-n-tab-content-1567710892\" role=\"tabpanel\" aria-labelledby=\"e-n-tab-title-1567710892\" data-tab-index=\"2\" style=\"--n-tabs-title-order: 2;\" class=\" elementor-element elementor-element-d998ee1 e-con-full e-flex e-con e-child\" data-id=\"d998ee1\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t\t\t<div class=\"elementor-element elementor-element-9fae7be elementor-position-left elementor-vertical-align-top elementor-widget elementor-widget-image-box\" data-id=\"9fae7be\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"image-box.default\">\n\t\t\t\t\t<div class=\"elementor-image-box-wrapper\"><figure class=\"elementor-image-box-img\"><img loading=\"lazy\" decoding=\"async\" width=\"200\" height=\"200\" src=\"https:\/\/hlsllc.org\/tos\/wp-content\/uploads\/2026\/04\/Thumbnail-Heart_Catheter.jpg\" class=\"attachment-full size-full wp-image-21241\" alt=\"\" \/><\/figure><div class=\"elementor-image-box-content\"><p class=\"elementor-image-box-description\">A flexible plastic catheter is inserted by a physician directly into an artery, usually in the groin. The physician advances the catheter under live x-ray (fluoroscopy) through the aorta, the main artery of the body, until it reaches the heart. At this point, the physician injects dye into the proximal aorta, after which the dye passes through the subclavian artery. As the dye passes through the arteries, x-rays create images. Direct angiography is an invasive test with a significant radiation dose. For this reason, CT angiography or MR angiography can almost always replace direct angiography.\n\n<\/p><\/div><\/div>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div id=\"e-n-tab-content-1567710893\" role=\"tabpanel\" aria-labelledby=\"e-n-tab-title-1567710893\" data-tab-index=\"3\" style=\"--n-tabs-title-order: 3;\" class=\" elementor-element elementor-element-8dd4056 e-con-full e-flex e-con e-child\" data-id=\"8dd4056\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t\t\t<div class=\"elementor-element elementor-element-58a85ee elementor-position-left elementor-vertical-align-top elementor-widget elementor-widget-image-box\" data-id=\"58a85ee\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"image-box.default\">\n\t\t\t\t\t<div class=\"elementor-image-box-wrapper\"><figure class=\"elementor-image-box-img\"><img loading=\"lazy\" decoding=\"async\" width=\"200\" height=\"200\" src=\"https:\/\/hlsllc.org\/tos\/wp-content\/uploads\/2026\/04\/Thumbnail-US-Neck-without-with-color-2.jpg\" class=\"attachment-full size-full wp-image-21245\" alt=\"\" \/><\/figure><div class=\"elementor-image-box-content\"><p class=\"elementor-image-box-description\">Ultrasound is performed without any radiation, and can demonstrate blood flow in the arteries in real time, allowing dynamic movement of the arms during the examination. However, bones create severe blind spots, limiting assessment of bony compression of arteries. Ultrasound is also quite limited for viewing fibrous bands and muscle anomalies.\n\n<\/p><\/div><\/div>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div id=\"e-n-tab-content-1567710894\" role=\"tabpanel\" aria-labelledby=\"e-n-tab-title-1567710894\" data-tab-index=\"4\" style=\"--n-tabs-title-order: 4;\" class=\" elementor-element elementor-element-ed2bd24 e-con-full e-flex e-con e-child\" data-id=\"ed2bd24\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t\t\t<div class=\"elementor-element elementor-element-76db0a3 elementor-position-left elementor-vertical-align-top elementor-widget elementor-widget-image-box\" data-id=\"76db0a3\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"image-box.default\">\n\t\t\t\t\t<div class=\"elementor-image-box-wrapper\"><figure class=\"elementor-image-box-img\"><img loading=\"lazy\" decoding=\"async\" width=\"200\" height=\"200\" src=\"https:\/\/hlsllc.org\/tos\/wp-content\/uploads\/2026\/04\/Thumbnail-CTA-Chest-Subclavian-Arteries-2.jpg\" class=\"attachment-full size-full wp-image-21246\" alt=\"\" \/><\/figure><div class=\"elementor-image-box-content\"><p class=\"elementor-image-box-description\">CT angiography is performed by injecting contrast into a peripheral vein, without an arterial catheter. CTA is fast, and shows excellent detail of bones and arteries. CTA requires significant radiation, and is limited in the evaluation of soft tissues, including fibrous bands and muscle anomalies. In cases of pure arterial TOS, CTA is the first-line test for many vascular surgeons.<\/p><\/div><\/div>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div id=\"e-n-tab-content-1567710895\" role=\"tabpanel\" aria-labelledby=\"e-n-tab-title-1567710895\" data-tab-index=\"5\" style=\"--n-tabs-title-order: 5;\" class=\" elementor-element elementor-element-c0e6cf7 e-con-full e-flex e-con e-child\" data-id=\"c0e6cf7\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t\t\t<div class=\"elementor-element elementor-element-2879464 elementor-position-left elementor-vertical-align-top elementor-widget elementor-widget-image-box\" data-id=\"2879464\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"image-box.default\">\n\t\t\t\t\t<div class=\"elementor-image-box-wrapper\"><figure class=\"elementor-image-box-img\"><img loading=\"lazy\" decoding=\"async\" width=\"200\" height=\"200\" src=\"https:\/\/hlsllc.org\/tos\/wp-content\/uploads\/2026\/04\/Thumbnail-Angio-MIP-1.jpg\" class=\"attachment-full size-full wp-image-21247\" alt=\"\" \/><\/figure><div class=\"elementor-image-box-content\"><p class=\"elementor-image-box-description\">MR angiography is performed by injecting contrast into a peripheral vein, without an arterial catheter. MRA shows excellent arterial detail while eliminating most other structures, including bones. It requires no radiation. If used in conjunction with MRI, superb soft tissue detail is available. Excellent depiction of fibrous bands, muscle anomalies, bones, and the brachial plexus is possible with MRI.\n\n<\/p><\/div><\/div>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-930efa8 elementor-widget elementor-widget-heading\" data-id=\"930efa8\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t\t<h2 class=\"elementor-heading-title elementor-size-default\">Treatment<\/h2>\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-91f16b9 elementor-widget elementor-widget-text-editor\" data-id=\"91f16b9\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t\t\t\t\t\t<div class=\"fusion-text fusion-text-6\"><div class=\"fusion-text fusion-text-7\"><div class=\"fusion-text fusion-text-9\"><p>Critical treatment decisions revolve around the presence or absence of a blood clot causing arterial occlusion. When present, acute arterial occlusion demands urgent treatment. When absent, surgeons can assess and treat patients with arterial TOS less urgently.<\/p><p>Read more about the treatment of patients with\u00a0arterial TOS\u00a0<a href=\"https:\/\/www.tosmri.com\/treatment-of-thoracic-outlet-syndrome\/treatment-of-arterial-thoracic-outlet-syndrome\/\">here<\/a>.<\/p><\/div><\/div><\/div>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-115c673 elementor-widget elementor-widget-text-editor\" data-id=\"115c673\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t\t\t\t\t\t\n\nThis interactive media demonstrates\u00a0MR angiography images in two patients. Swipe between the two to demonstrate a normal\u00a0MR angiogram and an\u00a0MR angiogram with bilateral extrinsic compression.\n\n\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-18855f0 elementor-widget-divider--view-line elementor-widget elementor-widget-divider\" data-id=\"18855f0\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"divider.default\">\n\t\t\t\t\t\t\t<div class=\"elementor-divider\">\n\t\t\t<span class=\"elementor-divider-separator\">\n\t\t\t\t\t\t<\/span>\n\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div class=\"elementor-element elementor-element-6866608 e-con-full e-flex e-con e-parent\" data-id=\"6866608\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t<div class=\"elementor-element elementor-element-3873885 e-con-full e-flex e-con e-child\" data-id=\"3873885\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t\t\t<div class=\"elementor-element elementor-element-d51a9dc elementor-widget elementor-widget-heading\" data-id=\"d51a9dc\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t\t<h2 class=\"elementor-heading-title elementor-size-default\">Imaging Diagnosis of Arterial TOS\n<\/h2>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div class=\"elementor-element elementor-element-0a3d799 e-con-full e-flex e-con e-child\" data-id=\"0a3d799\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t\t\t<div class=\"elementor-element elementor-element-e15dca5 elementor-widget-divider--view-line elementor-widget elementor-widget-divider\" data-id=\"e15dca5\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"divider.default\">\n\t\t\t\t\t\t\t<div class=\"elementor-divider\">\n\t\t\t<span class=\"elementor-divider-separator\">\n\t\t\t\t\t\t<\/span>\n\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div class=\"elementor-element elementor-element-122aba5 e-con-full e-flex e-con e-parent\" data-id=\"122aba5\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t<div class=\"elementor-element elementor-element-b39d5f0 e-con-full e-flex e-con e-child\" data-id=\"b39d5f0\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t\t\t<div class=\"elementor-element elementor-element-5b4deb6 elementor-widget elementor-widget-text-editor\" data-id=\"5b4deb6\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t\t\t\t\t\t<div class=\"fusion-title title fusion-title-text fusion-title-size-paragraph\"><div class=\"fusion-text\"><div class=\"fusion-li-item-content\"><div class=\"fusion-text fusion-text-1\"><div class=\"fusion-text fusion-text-1\"><div class=\"fusion-text fusion-text-4\"><div class=\"fusion-text fusion-text-11\"><p>Venous TOS is quite uncommon. However, the presentation of\u00a0venous TOS is quite dramatic, and complications can be serious. Venous TOS occurs when a blood clot forms in the main vein draining the arm. Although some treatment questions remain unsettled, doctors treat the blood clot urgently. Following this, doctors undertake diagnosis and treatment of the underlying cause.<\/p><\/div><\/div><\/div><\/div><\/div><\/div><\/div>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-1e4bca9 elementor-widget elementor-widget-image\" data-id=\"1e4bca9\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"image.default\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<img loading=\"lazy\" decoding=\"async\" width=\"600\" height=\"400\" src=\"https:\/\/hlsllc.org\/tos\/wp-content\/uploads\/2026\/04\/Female-Doctor-Scrubs-Clipboard-Cropped-Blue.jpg\" class=\"attachment-large size-large wp-image-21251\" alt=\"\" \/>\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-929e555 elementor-widget-divider--view-line elementor-widget elementor-widget-divider\" data-id=\"929e555\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"divider.default\">\n\t\t\t\t\t\t\t<div class=\"elementor-divider\">\n\t\t\t<span class=\"elementor-divider-separator\">\n\t\t\t\t\t\t<\/span>\n\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-6742c60 elementor-widget elementor-widget-heading\" data-id=\"6742c60\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t\t<h2 class=\"elementor-heading-title elementor-size-default\">Diagnosis\n<\/h2>\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-39b40cd elementor-widget elementor-widget-text-editor\" data-id=\"39b40cd\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t\t\t\t\t\t<p>Your doctor will examine the thoracic outlet on each side for the presence of a pulsatile mass. This mass may prove a subclavian artery aneurysm, or a normal subclavian artery passing over a cervical rib. With or without an aneurysm, your doctor may hear a\u00a0<i>bruit<\/i>\u00a0in the thoracic outlet with her stethoscope. A bruit is a swooshing sound caused by turbulent arterial blood flow. Narrowing of an artery may cause blood pressure in the two arms to be different.<\/p><p>Because of the risk of permanent damage, your physician will always look for signs of acute arterial insufficiency, including\u00a0<em><a class=\"_ps2id __mPS2id _mPS2id-h\" href=\"https:\/\/www.tosmri.com\/diagnosis-of-neurogenic-thoracic-outlet-syndrome\/diagnosis-of-arterial-thoracic-outlet-syndrome\/#5-ps\" data-ps2id-offset=\"\">the 5 Ps<\/a><\/em>\u00a0described above. Your physician will also look for signs of\u00a0arterial emboli. These signs include skin ulcerations and discoloration, and\u00a0<i>splinter hemorrhages<\/i>. Splinter hemorrhages are tiny emboli that travel from the damaged artery to small arteries in the fingers, causing tiny hemorrhages. Splinter hemorrhages are a sign of a proximal blood clot, usually in the arteries or heart. \u00a0Their presence indicates the need for evaluation of the arteries or heart as a source of emboli. Finally, your physician will look for signs of chronic arterial insufficiency, including trophic skin changes, as described above.<\/p><h3 class=\"fusion-responsive-typography-calculated\" data-fontsize=\"28\" data-lineheight=\"36.4px\">Imaging Tests<\/h3><p>Imaging tests are incredibly valuable tools in modern medicine. They are particularly valuable for a disease in a complex anatomic area like the thoracic outlet.<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-53a5cd8 e-n-tabs-mobile elementor-widget elementor-widget-n-tabs\" data-id=\"53a5cd8\" data-element_type=\"widget\" data-e-type=\"widget\" data-settings=\"{&quot;horizontal_scroll&quot;:&quot;disable&quot;}\" data-widget_type=\"nested-tabs.default\">\n\t\t\t\t\t\t\t<div class=\"e-n-tabs\" data-widget-number=\"87710936\" aria-label=\"Tabs. Open items with Enter or Space, close with Escape and navigate using the Arrow keys.\">\n\t\t\t<div class=\"e-n-tabs-heading\" role=\"tablist\">\n\t\t\t\t\t<button id=\"e-n-tab-title-877109361\" data-tab-title-id=\"e-n-tab-title-877109361\" class=\"e-n-tab-title\" aria-selected=\"true\" data-tab-index=\"1\" role=\"tab\" tabindex=\"0\" aria-controls=\"e-n-tab-content-877109361\" style=\"--n-tabs-title-order: 1;\">\n\t\t\t\t\t\t<span class=\"e-n-tab-title-text\">\n\t\t\t\tX-rays\t\t\t<\/span>\n\t\t<\/button>\n\t\t\t\t<button id=\"e-n-tab-title-877109362\" data-tab-title-id=\"e-n-tab-title-877109362\" class=\"e-n-tab-title\" aria-selected=\"false\" data-tab-index=\"2\" role=\"tab\" tabindex=\"-1\" aria-controls=\"e-n-tab-content-877109362\" style=\"--n-tabs-title-order: 2;\">\n\t\t\t\t\t\t<span class=\"e-n-tab-title-text\">\n\t\t\t\tAngiography\t\t\t<\/span>\n\t\t<\/button>\n\t\t\t\t<button id=\"e-n-tab-title-877109363\" data-tab-title-id=\"e-n-tab-title-877109363\" class=\"e-n-tab-title\" aria-selected=\"false\" data-tab-index=\"3\" role=\"tab\" tabindex=\"-1\" aria-controls=\"e-n-tab-content-877109363\" style=\"--n-tabs-title-order: 3;\">\n\t\t\t\t\t\t<span class=\"e-n-tab-title-text\">\n\t\t\t\tUltrasound \t\t\t<\/span>\n\t\t<\/button>\n\t\t\t\t<button id=\"e-n-tab-title-877109364\" data-tab-title-id=\"e-n-tab-title-877109364\" class=\"e-n-tab-title\" aria-selected=\"false\" data-tab-index=\"4\" role=\"tab\" tabindex=\"-1\" aria-controls=\"e-n-tab-content-877109364\" style=\"--n-tabs-title-order: 4;\">\n\t\t\t\t\t\t<span class=\"e-n-tab-title-text\">\n\t\t\t\tCTA\t\t\t<\/span>\n\t\t<\/button>\n\t\t\t\t<button id=\"e-n-tab-title-877109365\" data-tab-title-id=\"e-n-tab-title-877109365\" class=\"e-n-tab-title\" aria-selected=\"false\" data-tab-index=\"5\" role=\"tab\" tabindex=\"-1\" aria-controls=\"e-n-tab-content-877109365\" style=\"--n-tabs-title-order: 5;\">\n\t\t\t\t\t\t<span class=\"e-n-tab-title-text\">\n\t\t\t\tMRA\t\t\t<\/span>\n\t\t<\/button>\n\t\t\t\t\t<\/div>\n\t\t\t<div class=\"e-n-tabs-content\">\n\t\t\t\t<div id=\"e-n-tab-content-877109361\" role=\"tabpanel\" aria-labelledby=\"e-n-tab-title-877109361\" data-tab-index=\"1\" style=\"--n-tabs-title-order: 1;\" class=\"e-active elementor-element elementor-element-6f5ca7e e-con-full e-flex e-con e-child\" data-id=\"6f5ca7e\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t\t\t<div class=\"elementor-element elementor-element-6dafea9 elementor-position-left elementor-vertical-align-top elementor-widget elementor-widget-image-box\" data-id=\"6dafea9\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"image-box.default\">\n\t\t\t\t\t<div class=\"elementor-image-box-wrapper\"><figure class=\"elementor-image-box-img\"><img decoding=\"async\" width=\"200\" height=\"200\" src=\"https:\/\/hlsllc.org\/tos\/wp-content\/uploads\/2026\/04\/Thumbnail-CR-C-spine-Rt-C7-Elongation-and-Lt-Cervical-Rib.jpg\" class=\"attachment-full size-full wp-image-21240\" alt=\"\" \/><\/figure><div class=\"elementor-image-box-content\"><p class=\"elementor-image-box-description\">X-rays show excellent bone detail, but do not show soft tissue detail, and are limited to two dimensions. X-rays do not show arteries or veins. About 1% of the population has cervical ribs, but most of these people do not have arterial TOS. Even in patients with cervical ribs and arterial TOS, they have had cervical ribs their entire life, and only developed arterial TOS when they become symptomatic. X-rays thus have quite limited value in diagnosing arterial TOS and in planning treatment.\n\n<\/p><\/div><\/div>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div id=\"e-n-tab-content-877109362\" role=\"tabpanel\" aria-labelledby=\"e-n-tab-title-877109362\" data-tab-index=\"2\" style=\"--n-tabs-title-order: 2;\" class=\" elementor-element elementor-element-7f7f450 e-con-full e-flex e-con e-child\" data-id=\"7f7f450\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t\t\t<div class=\"elementor-element elementor-element-a0a010e elementor-position-left elementor-vertical-align-top elementor-widget elementor-widget-image-box\" data-id=\"a0a010e\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"image-box.default\">\n\t\t\t\t\t<div class=\"elementor-image-box-wrapper\"><figure class=\"elementor-image-box-img\"><img loading=\"lazy\" decoding=\"async\" width=\"200\" height=\"200\" src=\"https:\/\/hlsllc.org\/tos\/wp-content\/uploads\/2026\/04\/Thumbnail-Heart_Catheter.jpg\" class=\"attachment-full size-full wp-image-21241\" alt=\"\" \/><\/figure><div class=\"elementor-image-box-content\"><p class=\"elementor-image-box-description\">A flexible plastic catheter is inserted by a physician directly into an artery, usually in the groin. The physician advances the catheter under live x-ray (fluoroscopy) through the aorta, the main artery of the body, until it reaches the heart. At this point, the physician injects dye into the proximal aorta, after which the dye passes through the subclavian artery. As the dye passes through the arteries, x-rays create images. Direct angiography is an invasive test with a significant radiation dose. For this reason, CT angiography or MR angiography can almost always replace direct angiography.\n\n<\/p><\/div><\/div>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div id=\"e-n-tab-content-877109363\" role=\"tabpanel\" aria-labelledby=\"e-n-tab-title-877109363\" data-tab-index=\"3\" style=\"--n-tabs-title-order: 3;\" class=\" elementor-element elementor-element-f98a21d e-con-full e-flex e-con e-child\" data-id=\"f98a21d\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t\t\t<div class=\"elementor-element elementor-element-6d0d7df elementor-position-left elementor-vertical-align-top elementor-widget elementor-widget-image-box\" data-id=\"6d0d7df\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"image-box.default\">\n\t\t\t\t\t<div class=\"elementor-image-box-wrapper\"><figure class=\"elementor-image-box-img\"><img loading=\"lazy\" decoding=\"async\" width=\"200\" height=\"200\" src=\"https:\/\/hlsllc.org\/tos\/wp-content\/uploads\/2026\/04\/Thumbnail-US-Neck-without-with-color-2.jpg\" class=\"attachment-full size-full wp-image-21245\" alt=\"\" \/><\/figure><div class=\"elementor-image-box-content\"><p class=\"elementor-image-box-description\">Ultrasound is performed without any radiation, and can demonstrate blood flow in the arteries in real time, allowing dynamic movement of the arms during the examination. However, bones create severe blind spots, limiting assessment of bony compression of arteries. Ultrasound is also quite limited for viewing fibrous bands and muscle anomalies.\n\n<\/p><\/div><\/div>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div id=\"e-n-tab-content-877109364\" role=\"tabpanel\" aria-labelledby=\"e-n-tab-title-877109364\" data-tab-index=\"4\" style=\"--n-tabs-title-order: 4;\" class=\" elementor-element elementor-element-ee6a431 e-con-full e-flex e-con e-child\" data-id=\"ee6a431\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t\t\t<div class=\"elementor-element elementor-element-4b6b462 elementor-position-left elementor-vertical-align-top elementor-widget elementor-widget-image-box\" data-id=\"4b6b462\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"image-box.default\">\n\t\t\t\t\t<div class=\"elementor-image-box-wrapper\"><figure class=\"elementor-image-box-img\"><img loading=\"lazy\" decoding=\"async\" width=\"200\" height=\"200\" src=\"https:\/\/hlsllc.org\/tos\/wp-content\/uploads\/2026\/04\/Thumbnail-CTA-Chest-Subclavian-Arteries-2.jpg\" class=\"attachment-full size-full wp-image-21246\" alt=\"\" \/><\/figure><div class=\"elementor-image-box-content\"><p class=\"elementor-image-box-description\">CT angiography is performed by injecting contrast into a peripheral vein, without an arterial catheter. CTA is fast, and shows excellent detail of bones and arteries. CTA requires significant radiation, and is limited in the evaluation of soft tissues, including fibrous bands and muscle anomalies. In cases of pure arterial TOS, CTA is the first-line test for many vascular surgeons.<\/p><\/div><\/div>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div id=\"e-n-tab-content-877109365\" role=\"tabpanel\" aria-labelledby=\"e-n-tab-title-877109365\" data-tab-index=\"5\" style=\"--n-tabs-title-order: 5;\" class=\" elementor-element elementor-element-4a6459d e-con-full e-flex e-con e-child\" data-id=\"4a6459d\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t\t\t<div class=\"elementor-element elementor-element-5fa414b elementor-position-left elementor-vertical-align-top elementor-widget elementor-widget-image-box\" data-id=\"5fa414b\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"image-box.default\">\n\t\t\t\t\t<div class=\"elementor-image-box-wrapper\"><figure class=\"elementor-image-box-img\"><img loading=\"lazy\" decoding=\"async\" width=\"200\" height=\"200\" src=\"https:\/\/hlsllc.org\/tos\/wp-content\/uploads\/2026\/04\/Thumbnail-Angio-MIP-1.jpg\" class=\"attachment-full size-full wp-image-21247\" alt=\"\" \/><\/figure><div class=\"elementor-image-box-content\"><p class=\"elementor-image-box-description\">MR angiography is performed by injecting contrast into a peripheral vein, without an arterial catheter. MRA shows excellent arterial detail while eliminating most other structures, including bones. It requires no radiation. If used in conjunction with MRI, superb soft tissue detail is available. Excellent depiction of fibrous bands, muscle anomalies, bones, and the brachial plexus is possible with MRI.\n\n<\/p><\/div><\/div>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-4207c5f elementor-widget-divider--view-line elementor-widget elementor-widget-divider\" data-id=\"4207c5f\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"divider.default\">\n\t\t\t\t\t\t\t<div class=\"elementor-divider\">\n\t\t\t<span class=\"elementor-divider-separator\">\n\t\t\t\t\t\t<\/span>\n\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-1d8a7a6 elementor-widget elementor-widget-heading\" data-id=\"1d8a7a6\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t\t<h2 class=\"elementor-heading-title elementor-size-default\">Interactive Media\n<\/h2>\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-e6c1389 elementor-widget elementor-widget-text-editor\" data-id=\"e6c1389\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t\t\t\t\t\t<div class=\"fusion-text fusion-text-13\"><p>This interactive media demonstrates\u00a0magnetic resonance angiography (MRA) images in two different patients. One patient has a normal MRA. The other patient has compression of each subclavian artery. Note that the structures that cause this compression are not visible on MRA alone.<\/p><\/div>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-072f35b elementor-widget elementor-widget-aic-image-comparison\" data-id=\"072f35b\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"aic-image-comparison.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t        \n        <div id=\"aic-image-comparison-072f35b\" class=\"aic-image-container\" data-offset=\"0.5\" data-orientation=\"horizontal\" data-before_label=\"Before\" data-after_label=\"After\" data-overlay=\"no\" data-onhover=\"yes\" data-click_to_move=\"no\">\n\t\t\t<img decoding=\"async\" class=\"aic-before-img\" alt=\"Before image alt\" src=\"https:\/\/hlsllc.org\/tos\/wp-content\/uploads\/2026\/04\/Swipe-reveal-Angio-MIP-1-600x448-1.jpg\">\n\t\t\t<img decoding=\"async\" class=\"aic-after-img\" alt=\"After image alt\" src=\"https:\/\/hlsllc.org\/tos\/wp-content\/uploads\/2026\/04\/Swipe-reveal-MRA-Cerv-Rib-CCI-Sten-AT-4-1-600x450-1.jpg\">\n        <\/div>\n\n        \t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-23c3e8b elementor-widget-divider--view-line elementor-widget elementor-widget-divider\" data-id=\"23c3e8b\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"divider.default\">\n\t\t\t\t\t\t\t<div class=\"elementor-divider\">\n\t\t\t<span class=\"elementor-divider-separator\">\n\t\t\t\t\t\t<\/span>\n\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t","protected":false},"excerpt":{"rendered":"<p>Diagnosis of Arterial Thoracic Outlet Syndrome Symptoms of Venous TOS Arterial TOS is rare and quite serious. The symptoms of arterial TOS are often sudden and severe. These symptoms are caused by sudden occlusion of one or more arteries in the affected arm. Arterial occlusion blocks blood flow to the arm, which may lead to [&hellip;]<\/p>\n","protected":false},"author":1,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"footnotes":""},"class_list":["post-21214","page","type-page","status-publish","hentry"],"_links":{"self":[{"href":"https:\/\/hlsllc.org\/tos\/wp-json\/wp\/v2\/pages\/21214","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/hlsllc.org\/tos\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/hlsllc.org\/tos\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/hlsllc.org\/tos\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/hlsllc.org\/tos\/wp-json\/wp\/v2\/comments?post=21214"}],"version-history":[{"count":9,"href":"https:\/\/hlsllc.org\/tos\/wp-json\/wp\/v2\/pages\/21214\/revisions"}],"predecessor-version":[{"id":21719,"href":"https:\/\/hlsllc.org\/tos\/wp-json\/wp\/v2\/pages\/21214\/revisions\/21719"}],"wp:attachment":[{"href":"https:\/\/hlsllc.org\/tos\/wp-json\/wp\/v2\/media?parent=21214"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}