Thoracic Outlet Syndrome: An Overlooked Diagnosis in the Pediatric Population.

Abstract

Thoracic outlet syndrome (TOS) results from the compression of the brachial plexus and/or subclavian vessels. The diagnosis of this disorder in children is often overlooked because of the mistaken assumption that the disorder does not affect children. There is a lack of knowledge concerning the etiology, treatment, and long-term results of this pathology among younger patients. We present a case of a 14-year-old girl with paresthesia and weakness of the upper right limb due to an ipsilateral cervical rib. The severity of her complaints motivated the use of surgical decompression by the supraclavicular approach. After a 6-month follow-up period and after an active rehabilitation and strength training program, the patient was free of symptoms. Thoracic outlet syndrome etiology, treatment choices, and outcomes in the pediatric population remain debatable. Conservative treatment is steered mainly to improving the patient's posture during the activities of daily living by mitigating the compression on the brachial plexus. Surgical decompression is the treatment of choice for patients with persistent significant symptoms.