Thoracic Outlet Syndrome

Case 60

ICU/Surgery / Age 31-60, Cholecystectomy, Clavicle, Claviculectomy, Stent, Subclavian Vein Stent, Thoracic Outlet Syndrome

This radiograph shows a patient with a left claviculectomy for venous thoracic outlet syndrome. This is an uncommon surgical treatment for this condition, with first rib resection being more common. In some cases a clavicle fracture with subsequent malunion or nonunion can case thoracic outlet syndrome and can be treated with claviculectomy or corrective clavicle osteotomy. A left subclavian venous stent is also in place, another possible treatment for venous thoracic outlet syndrome.

Surgical clips are seen in the right upper quadrant, most likely from cholecystectomy. Two surgical clips are also present in the left breast. The exam is otherwise unremarkable.

Case 60 Read More »

Case 47

This radiograph demonstrates bilateral cervical ribs, right greater than left. They are congenital and may be of no clinical significance. In some individuals, it can cause or contribute to thoracic outlet syndrome by compressing the subclavian vein, artery, and/or nerve. Cervical ribs may be resected in these cases.

There is also an incidental small, dense (likely calcified) nodule in the right lower lung and a probable calcified right hilar lymph node. This patient lives in an endemic area for Histoplasma capsulatum. Remote infection is the most likely etiology.