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October 1951

PAGET-SCHROETTER SYNDROMEReport of a Case of One of the More Unusual Neurovascular Syndromes of the Upper Limb

AMA Arch Intern Med. 1951;88(4):507-511. doi:10.1001/archinte.1951.03810100091009

THE PAGET-SCHROETTER syndrome is identified with the symptomatology of a neurovascular disease of the upper limb, the predominant lesion of which is obstruction of the axillary vein.

Among the many causes of shoulder pain the neurovascular syndromes occupy a unique and puzzling position. As the neural and vascular elements of the upper limb pass from the cervical and thoracic regions to converge and proceed into the axilla, they become vulnerable to minor trauma by the firmer supporting structures. Trauma by a cervical rib,1 by a hypertrophied scalenus anticus muscle,2 by a prevenous phrenic nerve,3 by the lower border of the subclavius muscle and the costoclavicular ligament,4 or by the clavicle and first rib5 is a potentiality in 50 to 80% of adults.6

The vulnerable elements are the motor, sensory, and autonomic components of the brachial plexus, the axillary artery, and the axillary vein. They are subject to sudden, or continuous,