Turkish Journal of Physical Medicine and Rehabilitation 2010 , Vol 56 , Num 4

Diagnostic Values of Clinical Diagnostic Tests in Thoracic Outlet Syndrome

Mustafa Çalış 1 ,Mehmet Altuncuoğlu 2 ,Ayşin Demirel 2
1 Erciyes Üniversitesi Tıp Fakültesi Fiziksel Tıp ve Rehabilitasyon Anabilim Dalı, Kayseri
2 Erciyes Üniversitesi Tıp Fakültesi, Fiziksel Tıp ve Rehabilitasyon Anabilim Dalı, Kayseri, Türkiye
DOI : 10.4274/tftr.56.155

Objective: The aim of this study was to demonstrate the diagnostic values of clinical diagnostic tests for thoracic outlet syndrome (TOS).

Materials and Methods: The study was performed on 135 patients who had neck and arm pain. Of these patients, 93 had TOS and 42 had diseases other than TOS. Two blinded investigators performed the Adson’s test, costoclavicular test, Roos test, supraclavicular Tinel’s sign, Halstead’s maneuver, hyperabduction test and the Allen’s test, which are special diagnostic methods  used in TOS. The sensitivity, specificity, accuracy, and the positive and negative predictive values of these tests were calculated.

Results: The sensitivities of clinical diagnostic tests found by the first investigator given in decreasing order are as follows:  92.47% for the Roos test, 74.19% for the Halstead’s maneuver, and 67.74% for the supraclavicular Tinel’s sign; the results of the second investigator were: 92.47% Roos test, 76.34% Halstead’s maneuver and 67.74% costoclavicular test. Regarding combination of tests, the highest sensitivity rates calculated using at least two tests were 90.44% and 90.74% estimated by the first and the second investigator, respectively.

Conclusion: This study demonstrated that the most sensitive tests in the diagnosis of TOS are the Roos test, Halstead’s maneuver, supraclavicular Tinel’s sign and the costoclavicular  test.

Keywords : Thoracic outlet syndrome, diagnostic tests, clinical evaluation, diagnostic values