Symptoms & signs due to compression of brachial plexus & /or subclavian vessels at root of neck
80% 30-50 years
F:M = 2:1
Uncommon
Thoracic Outlet forms communication at root of neck
- for passage of nerves and vessels from mediastinum to axilla
1. Spinal dysraphism
Failure of the neural tube to close (i.e. spina bifida + failure of neural tube development)
May see one of 5 telltale skin defects
- tail
- skin dimpling
- sacral pit
- hair tuft
- lipoma
Myelodysplasia: Any developmental defect of the spinal cord
2. Spina Bifida Cystica
Diffuse Idiopathic Skeletal Hyperostosis
- non-inflammatory disease
- ossifying enthesopathy / bone forming diasthesis
- most commonly involves spine / anterior longitudinal ligament
AKA Forestier's disease
Ankylosing Spondylosis
DISH
- non inflammatory
- no facet or SIJ involvement
- no squaring of anterior vertebral body