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Kyphosis contributes to costoclavicular compression in patients with thoracic outlet syndrome and migraine: MRI/MRA/MRV
Author(s) -
Saxton Ernestina H.,
Collins James D.,
Miller Theodore Q.,
Ahn Samuel S.,
Carnes Alfred
Publication year - 2007
Publication title -
the faseb journal
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.709
H-Index - 277
eISSN - 1530-6860
pISSN - 0892-6638
DOI - 10.1096/fasebj.21.5.a600
Subject(s) - medicine , kyphosis , rib cage , radiology , magnetic resonance imaging , neurovascular bundle , anatomy , radiography
Magnetic resonance imaging (MRI), angiography (MRA) and venography (MRV) display venous and neurovascular compression in patients with thoracic outlet syndrome (TOS) and migraine ( Clin.Anat .1995; 8 :–16). Kyphosis of the cervicothoracic spine enhances costoclavicular compression ( JNMA . 2003; 95 :–306). Causes of kyphosis (and examples) include congenital and developmental anomalies (achondroplasia, dysraphism, Scheuremann's), connective tissue disorders (Ehler's‐Danlos), infection (Pott's), neoplasm, trauma, immobilization, and aging with muscle and tissue laxity. Kyphosis increases the slope of the first ribs; backwardly displaces the manubrium sterni and narrows the thoracic inlet, with resultant compression of the brachiocephalic, internal jugular and subclavian veins and the subclavian artery and binding nerve roots in the scalene triangle. Abduction and external rotation of the upper extremities increases TOS symptoms of pain, numbness and tingling, temperature and color changes in the hands and headache. Multiplanar imaging of suspected TOS patients with kyphosis was conducted on the 1.5 Tesla (GE Signa LX), 4.0 mm thickness, 512 × 256 matrix and saline water bags to enhance signal to noise ratio. Blood flow was displayed as changes in proton density without contrast. This presentation displays TOS patients with kyphosis causing venous and neurovascular compression.