Author Affiliation: Division of Vascular Surgery, Department of Surgery, University of South Florida College of Medicine, Tampa.
Chang and colleagues1 from The Johns Hopkins Medical Institutions have provided us with a very helpful review of TOS occurring in adolescent patients. While a limited number of similar studies have previously been published, this is by far the largest series and large enough, I think, to provide meaningful data.
Thoracic outlet syndrome is a “fuzzy” diagnosis; it is a real entity but one that is difficult to diagnose and that overlaps with multiple other problems. In adults, results are sometimes poor and the waters muddy. To a large extent, this is because adults often have numerous other factors in play, including liability and secondary gain issues, substance dependency and/or abuse, chronic regional pain syndrome, and underlying psychological disorders. The beauty of treating adolescents is that these factors are almost never in play; apart from the occasional case of Munchausen syndrome by proxy, adolescents with complaints of TOS have clear, unequivocal problems.
Illig KA. Thoracic Outlet Syndrome in Adolescents Is RealComment on “Spectrum of Thoracic Outlet Syndrome Presentation in Adolescents”. Arch Surg. 2011;146(12):1388. doi:10.1001/archsurg.2011.1026