The following about thoracic outlet syndrome is true

Thoracic outlet syndrome can be caused by a cervical rib or a fibrous band from the C7 transverse process to the first rib. Compression of the lower brachial plexus roots (C8, T1) and subclan aery explains the symptoms and signs: neural compression causes radicular arm pain with wasting, weakness and numbness in a C8/T1 distribution. Investigation may include plain cervical radiograph, nerve conduction studies and brachial plexus MRI. Treatment is by surgical decompression, dividing the fibrous band or removing the cervical rib.The lower trunk of the plexus (mainly T1) is compressed, leading to wasting of the interossei and altered sensation in the T1 distribution. Compression of the subclan aery may result in a post-stenotic dilatation with thrombus and embolus formation. The diagnosis, assessment and surgery are fraught with unceainties and are best left to those with a well-developed interest in this problem. Bailey & Love,25th,895,642