다른 질환으로 오인되기 쉬웠던 흉곽 출구 증후군 3례

Abstract

Introduction: Thoracic outlet syndrome (TOS) referes to compression of one or more of the neurovascular structures traversing the superior aperture of the chest. 3 cases reported in this article are diagnosed as TOS among patients who was misdiagnosed of another diseases. Case 1: 29 years old female was diagnosed as ulnar neuropathy. She took operation but neurologic symptoms were not improved. Therefore she was carried out the electro-diagnostic studies and the result showed possibility of TOS. Scalene muscle block was done and she diagnosed TOS based on symptomatic improvement. Case 2: 37 years old female was diagnosed as herniation of intervertebral disc of C3-C6. But electrodiagnostic studies showed diagnostic possibility of TOS. Scalene muscle block was done and she diagnosed TOS based on symptomatic improvement. Case 3: 18 years old male who had history of TOS with surgical treatment. After 18 months, numbness of right upper limb occurred and the patient was diagnosed as Hirayama disease. And he was treated with physical therapy and medications but his symptoms were progressed slowly. So the patient was carried out reevaluation including electrodiagnostic studies and diagnosed as TOS. Conclusion: In 3 cases diagnosed as TOS, it was misdaignosed as another diseases due to similar neurologic symptoms between TOS and each disease. Precise electrodiagnostic studies and symptomatic improvement after scalene muscle block are essential to diasgnosis of TOS.