Invited Critique |

Thoracic Outlet Syndrome in Adolescents Is Real:  Comment on “Spectrum of Thoracic Outlet Syndrome Presentation in Adolescents”

Karl A. Illig, MD
Arch Surg. 2011;146(12):1388. doi:10.1001/archsurg.2011.1026.
Text Size: A A A
Published online


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.

Sign In to Access Full Content

Don't have Access?

Register and get free email Table of Contents alerts, saved searches, PowerPoint downloads, CME quizzes, and more

Subscribe for full-text access to content from 1998 forward and a host of useful features

Activate your current subscription (AMA members and current subscribers)

Purchase Online Access to this article for 24 hours

First Page Preview

View Large
First page PDF preview





Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.
Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s "Cited By" API will populate this tab (http://www.crossref.org/citedby.html).
Submit a Comment


Some tools below are only available to our subscribers or users with an online account.

Sign In to Access Full Content

Related Content

Customize your page view by dragging & repositioning the boxes below.

See Also...
Articles Related By Topic
Related Topics
PubMed Articles
Nerve entrapment syndromes in musicians. Clin Anat Published online Mar 18, 2014.;