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KMID : 0860920120140010017
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Journal of the Korean Association EMG-Electrodiagnostic Medicine
2012 Volume.14 No. 1 p.17 ~ p.23
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Significance of electrodiagnostic study in patients with classical thoracic outlet syndrome
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Lee Do-Hong
Kim Jung-Yoon
Han Tai-Ryoon
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Abstract
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Objectives: To investigate the relationship between the findings of the electrodiagnostic study (EDX) and clinical evaluation in patients with classical thoracic outlet syndrome (TOS).
Methods: Retrospective medical record review was done in 49 patients (age 46.7±15.1 years, 19 men) with clinically suspected TOS, referred for EDX from October 2003 to March 2010. EDXs were performed at 24.1±33.7 months from symptom onset. Ulnar and median, sensory and motor nerve conduction studies (NCS) were done in all patients and the medial antebrachial cutaneous nerve (MAC) NCS was done in 27 patients. Needle electromyography (EMG) was conducted in all subjects, covering at least one of those muscle-abductor pollicis brevis (APB), first dorsal interossei (FDI), abductor digiti minimi (ADM) and C8 paraspinal muscles.
Results: 10 patients were diagnosed with classical TOS. Paresthesia was most common symptom. Hyperabduction test(80%) and Adson’s test(71.4%) were sensitive provocation test. In radiologic study, CT and MRI was more sensitive(57.1%) than simple X-ray(40%). In EMG study, MAC NCS and FDI, ADM, APB, EIP(extensor indicis proprius) needle EMG were sensitive.
Conclusion: The most sensitive EDX to detect TOS was MAC NCS. Paresthesia was the most common symptom, Hyperabduction test and Adson’s test were effective provocation tests.
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KEYWORD
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Thoracic outlet syndrome, Medial antebrachial cutaneous nerve, Paresthesia
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