ArticleBMC musculoskeletal disorders2023
Diagnosis of thoracic outlet syndrome with the lower trunk compression of brachial plexus by high-frequency ultrasonography.
Article in BMC musculoskeletal disorders, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
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Who cites it
4 citing papers in PubMed, 5 citations in OpenAlex.
- Neuromuscular ultrasound of the brachial plexus: know-how, know-when.Clinical neurophysiology practice · 2026Review
- Thoracic Outlet Syndrome Case Report: Appropriate Diagnosis Can Expedite Patient Treatment and Prevent Negative Outcomes.Clinical practice and cases in emergency medicine · 2025Article
- Imaging features of the brachial plexus in neurogenic thoracic outlet syndrome: A case report.Radiology case reports · 2025Article
- Don't be perplexed by the plexus! A practical approach to brachial plexus ultrasound.BJR open · 2025Review
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Authors and funding
6 authors at 1 institution in 1 country.
Funding
Abstract
backgroundThoracic outlet syndrome (TOS) with the lower trunk compression of brachial plexus (BP) is difficult to diagnosis. This study aimed to summarize the features of thoracic outlet syndrome (TOS) with the lower trunk compression of brachial plexus observed on high-frequency ultrasonography (HFUS).
methodsThe ultrasound data of 27 patients who had TOS with the lower trunk compression of brachial plexus were collected and eventually confirmed by surgery. The imaging data were compared, and the pathogenesis of TOS was analyzed on the basis of surgical data.
resultsTOS occurred predominantly in females (70.4%). Most cases had unilateral involvement (92.6%), mainly on the right side (66.7%). The HFUS features of TOS can be summarized as follows: (1) Lower trunk compression. HFUS revealed focal thinning that reflected compression at the level of the lower trunk; furthermore, the distal part of the nerve was thickened for edema (Affected side: 0.49 ± 0.12 cm vs. Healthy side: 0.38 ± 0.06, P = 0.009), and the cross-sectional area of brachial plexus cords was markedly greater on the injured side than on the healthy side (0.95 ± 0.08 cm² vs. 0.65 ± 0.11 cm², P = 0.004). (2) Hyperechoic fibromuscular bands behind the compressed nerve (mostly the scalenus minimus muscle). (3) Abnormal bony structures: cervical ribs or elongated transverse processes of the 7th cervical vertebra (C7). Surgical results showed that the etiological factors contributing to TOS were (1) muscle hypertrophy and/or fibrosis (100%) and (2) cervical ribs/elongated C7 transverse processes (20.7%).
conclusionTOS with the lower trunk compression of brachial plexus can be diagnosed accurately and reliably by high-frequency ultrasound.
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