Etiology of neurogenic thoracic outlet syndrome

There is an anatomic basis for the symptom complex in patients who have thoracic outlet syndrome. For treatment to be effective, whether it is surgical or nonsurgical, the anatomic etiology of the symptoms must be understood. Without understanding the underlying anatomic variations in the thoracic outlet that adversely affect the brachial plexus and subclavian vessels, a patient's complex presentation becomes a conundrum of vague symptoms inexplicable by a routine physical examination. The understanding of anatomic aspects has evolved and continues to do so. With the advent of more detailed imaging techniques, cross specialty discussions are even more important in providing advances in understanding.