Thoracic Outlet Syndrome in the Overhead Athlete: A Report of 2 Cases of Subclavius Posticus Muscle.

Clin J Sport Med

*Regenerative and Reconstructive Orthopaedic Surgery Unit, IRCCS Istituto Ortopedico Galeazzi, Milan, Italy; †Residency Program in Orthopaedic Surgery, University of Milan, Italy; ‡Department of Radiology, San Raffaele Scientific Institute, Milan, Italy; §Department of Biomedical Sciences for H

Published: May 2017


Category Ranking

98%

Total Visits

921

Avg Visit Duration

2 minutes

Citations

20

Article Abstract

Subclavius posticus muscle is a supernumerary anatomical variation of the subclavius muscle. The aim of this study was to show the possible contribution of the posticus muscle in the development of unilateral thoracic outlet syndrome (TOS) in overhead athletes, presenting hypertrophy of the dominant arm due to their sport activity. Reported here are 2 young overhead athletes complaining pain, paresthesia, weakness in the dominant upper limb, although presenting none of the main shoulder and neurological disorders. After developing subclavian vein thrombosis, TOS was suspected and finally diagnosed by dynamic magnetic resonance angiography, which also showed bilateral subclavius posticus muscle in both patients. Despite bilateral subclavius posticus, TOS was only evident in the dominant limb in which the association of hypertrophy of lateral cervical muscles, resulting from the overhead sport activity, to the subclavius posticus likely led to a significant reduction of the upper thoracic outlet space.

Download full-text PDF

Source
http://dx.doi.org/10.1097/JSM.0000000000000329DOI Listing

Publication Analysis

Top Keywords

subclavius posticus
20
posticus muscle
16
thoracic outlet
12
outlet syndrome
8
overhead athletes
8
sport activity
8
bilateral subclavius
8
subclavius
6
posticus
6
muscle
5

Similar Publications

Purpose: This study provides an insight on the extent of muscular variability at the suprascapular notch and elaborates on its anatomical interference in suprascapular nerve arthroscopic decompression procedures.

Methods: The suprascapular notch was dissected and its muscular topography was observed in 115 cadaveric specimens. High resolution imaging of the suprascapular notch was captured by a handheld digital microscope (Q-scope).

View Article and Find Full Text PDF

Background: Thoracic outlet syndrome (TOS) is a clinical diagnosis caused by compression of neurovascular structures in the thoracic outlet. There are a variety of structures that cause compression implicated in TOS. TOS patients frequently require surgical decompression.

View Article and Find Full Text PDF

Background: The subclavius muscle runs underneath the clavicle. However, there have been a few reports of a duplicated subclavius muscle which is commonly referred to as subclavius posticus muscle due to its orientation being posterior to the proper subclavius muscle. Its occurrence seems to potentially create a narrowing interval at the superior thoracic aperture as it crosses over the brachial plexus.

View Article and Find Full Text PDF

The subclavius posticus muscle is a rare aberrant muscle that traverses from the costal cartilage of the first rib posterolaterally to the superior border of the scapula. We report a patient having persistent paralysis of shoulder abduction with wrist and finger extension after a humeral neck fracture. Electromyography (EMG) examination revealed injuries to several upper extremity peripheral nerves, including the radial, axillary, and musculocutaneous nerves.

View Article and Find Full Text PDF

Case: We reported a dynamic neurogenic left thoracic outlet syndrome (TOS) with a permanent abduction of the fifth left finger. Preoperative magnetic resonance imaging (MRI) assessed the presence of subclavius posticus muscle (SPM). Because of a nonoperative treatment failure, we performed a brachial plexus neurolysis and SPM resection.

View Article and Find Full Text PDF