Computed tomography in terms of thoracic outlet syndrome diagnosis

Thoracic outlet syndrome (TOS) comprises a group of clinical syndromes caused by congenital or acquired compression of the brachial plexus or subclavian vessels during their passage through the superior thoracic aperture.Clinical manifestations vary by TOS type: neurogenic form (arm pain/paresthesia, hand muscle weakness, thenar atrophy), venous form (limb edema/cyanosis, visible collaterals, subclavian vein thrombosis), arterial form (arm ischemia, distal emboli, subclavian artery aneurysms).The modern diagnostic algorithm includes physical examination (Edson test, Wright test, hyperabduction test) and instrumental diagnostic methods. These include radiography to detect bone abnormalities, ultrasound with Doppler to assess blood flow, MRI to assess soft tissue structures, and CT angiography, which is the "gold standard" for diagnosing vascular forms of TOS.In the presented case, dynamic CT angiography revealed a rare instance of bilateral TOS in a patient with a long-standing history of shoulder girdle pain, caused by clavicular hyperostosis, dynamic subclavian vein compression, chronic thrombosis signs.TOS requires comprehensive diagnostics with advanced imaging. Dynamic CT angiography is the preferred confirmatory method. Early diagnosis prevents severe complications (thrombosis, ischemia). Personalized 3D modeling enhances treatment outcomes and surgical planning. Thus, an integrated diagnostic approach helps to prevent the progression of the disease and helps in planning surgical treatment.