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Differential Diagnosis of Neurogenic Thoracic Outlet Syndrome: A Review

College of Medicine, University of Sulaimani, Madam Mitterrand Street, Sulaymaniyah, Iraq
College of Medicine, University of Sulaimani, Madam Mitterrand Street, Sulaymaniyah, Iraq
Scientific Affairs Department, Smart Health Tower, Madam Mitterrand Street, Sulaymaniyah, Iraq
Scientific Affairs Department, Smart Health Tower, Madam Mitterrand Street, Sulaymaniyah, Iraq
College of Pharmacy, Department of Basic science, University of Sulaimani, Madam Mitterrand Street, Sulaymaniyah, Iraq
Rheumatology Department, Ministry of Health, Shorsh Street, Sulaymaniyah, Iraq
Scientific Affairs Department, Smart Health Tower, Madam Mitterrand Street, Sulaymaniyah, Iraq
College of Medicine, University of Sulaimani, Madam Mitterrand Street, Sulaymaniyah, Iraq
Scientific Affairs Department, Smart Health Tower, Madam Mitterrand Street, Sulaymaniyah, Iraq
Rheumatology Department, Ministry of Health, Shorsh Street, Sulaymaniyah, Iraq
Scientific Affairs Department, Smart Health Tower, Madam Mitterrand Street, Sulaymaniyah, Iraq
Scientific Affairs Department, Smart Health Tower, Madam Mitterrand Street, Sulaymaniyah, Iraq
Kscien Organization for Scientific Research (Middle East office), Hamdi Str, Azadi Mall, Sulaymaniyah, Iraq
Scientific Affairs Department, Smart Health Tower, Madam Mitterrand Street, Sulaymaniyah, Iraq
Kscien Organization for Scientific Research (Middle East office), Hamdi Str, Azadi Mall, Sulaymaniyah, Iraq
Department of Biology, College of Education, University of Sulaimani, Madam Mitterrand Street, Sulaymaniyah, Iraq

Abstract

Thoracic outlet syndrome (TOS) is a complex and often overlooked condition caused by the compression of neurovascular structures as they pass through the thoracic outlet. This compression can result in pain, numbness, tingling, muscle weakness, and vascular complications, with severe cases leading to thrombosis or embolism.

TOS is classified into three types based on the affected structure: neurogenic, venous, and arterial. Neurogenic TOS is the most prevalent, accounting for over 90% of cases, and is more commonly seen in females. Venous TOS represents 3–5% of cases, while arterial TOS is the rarest, comprising only 1%. Diagnosing TOS is challenging due to its symptom overlap with various musculoskeletal and neurological disorders, often leading to misdiagnosis. The absence of universally accepted diagnostic criteria further complicates identification, relying primarily on clinical evaluations and inconsistent diagnostic methods.

Neurogenic TOS, in particular, is difficult to distinguish from other conditions with similar presentations. This study provides a comprehensive review of the differential diagnosis of neurogenic TOS, comparing it with musculoskeletal and neurological disorders that share overlapping clinical features.

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