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Congenital and acquired atrophy of the shoulder girdle muscles in thoracic outlet syndrome (TOS) patients displayed by MRI/MRA/MRV: Sprengel's deformity and poliomyelitis
Author(s) -
Collins James D.,
Saxton Ernestina H.,
Miller Theodore Q.,
Ahn Samuel S.,
Carnes Alfred
Publication year - 2008
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.22.1_supplement.583.4
Subject(s) - medicine , brachial plexus , anatomy , scapula , rib cage , accessory nerve , deformity , shoulder girdle , subclavian artery , axillary artery , thoracic outlet syndrome , radiology
Bilateral MRI/MRA/MRV displays abnormalities of the osseous structures and soft tissues of the cervicothoracic spine that disrupt fascial planes of the brachial plexus and compress the lymphatics, veins and arteries that supply the nerves. Congenital osseous abnormalities include cervical ribs, synchondrosis, Klippel‐Feil and Sprengel's deformity, among many others. Acquired abnormalities, including inflammatory, traumatic, neoplastic and infectious, also cause symptoms of thoracic outlet syndrome. Monitored multiplanar MRI/MRA/MRV displays sites of compression of the brachial plexus. Images were acquired on a 1.5 Tesla GE Signa unit, 44 cm field of view and saline water bags to enhance signal to noise ratio. This presentation displays an adult Sprengel's deformity and the sequelae of childhood polio resulting in costoclavicular compression of the bicuspid valves within the draining veins within the neck, supraclavicular fossae, and of the subclavian and axillary arteries with binding nerve roots. In both Sprengel's and polio the patients had significant atrophy of the shoulder muscles with costoclavicular compression. The patient with Sprengel's deformity had acute sloping ribs with tension on the sternocleidomastoid and scalene muscles. The omovertebral bar was not fused to the scapula. The patient with polio also ruptured his carotid artery lifting a heavy object and required stent placement.