Thoracic Outlet Syndrome (TOS) Explained | TOS Classification

TOS is not an actual diagnosis according to the International Classification of Diseases(ICD), but a symptom complex. It is detected by the exclusion of other pathologies that can provoke neurological or vascular arm symptoms like cervical radicular syndrome and carpal tunnel syndrome.

TOS can be further divided into 4 different classifications:

According to Davidovic et al. (2003) the incidence of TOS is as high as 8% and it is said to be pretty rare in children with a ratio of males to females of 1:2 to 1:4. Furthermore,98% of the causes are neurogenic, while 2% are due to vascular compression.

Common tests to assess for TOS are:

• Adson Test
• Eden/Military Brace Test
• Wright’s Test
• Tinel’s Sign
• Morley / Brachial Plexus Compression Test
• Cyriax Release Test
• Costoclavicular Maneuver / Halstead Test

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Davidovic, L. B., Kostic, D. M., Jakovljevic, N. S., Kuzmanovic, I. L., & Simic, T. M. (2003). Vascular thoracic outlet syndrome. World journal of surgery, 27(5), 545-550.

Watson, L. A., Pizzari, T., & Balster, S. (2009). Thoracic outlet syndrome part 1: clinical manifestations, differentiation and treatment pathways. Manual therapy, 14(6), 586-595.

Watson, L. A., Pizzari, T., & Balster, S. (2010). Thoracic outlet syndrome part 2: conservative management of thoracic outlet. Manual therapy, 15(4), 305-314.