Reply To: Patient Case Discussion

[Tyler France]

Structues to Assess:

Ant and Mid Scalene: Palpation for hypertrophy or increased turgor/trigger points that may cause reproduction of distal symptoms. Can also perform Adson’s test if suspecting vascular TOS.

First Rib: Can perform cervical rotation-lateral flexion test or palpate for hypomobility with breathing. We probably should have checked CRLF in our patient, but we were scrambling a bit when she kept asking to change positions.

Pec Minor: Observation of scapular positioning at rest and palpation of pec minor for turgor.

GH Mobility: Palpating for position of the humeral head and assessing GHJ mobility, particularly posteriorly.

Has anyone used the prominent TOS special tests (Adson’s, Roo’s, Costoclavicular, etc) in their practice and do you feel that you can comfortably diagnose TOS without performing these tests?