Differential Diagnosis for Thoracic Outlet Syndrome
- Single Most Likely Diagnosis
- Thoracic outlet syndrome (TOS) itself: This is the most likely diagnosis given the question, as the symptoms and presentation are likely consistent with compression or irritation of the nerves and/or blood vessels in the thoracic outlet.
- Other Likely Diagnoses
- Cervical radiculopathy: This condition involves compression or irritation of the nerve roots in the cervical spine, which can cause similar symptoms to TOS, such as pain, numbness, and weakness in the arm.
- Rotator cuff tendinitis or tear: Shoulder injuries can cause pain and limited mobility that might be confused with TOS symptoms.
- Brachial plexitis (neuralgic amyotrophy): Inflammation of the brachial plexus can cause severe pain and weakness in the shoulder and arm, mimicking some TOS symptoms.
- Do Not Miss Diagnoses
- Pulmonary embolism: Although less likely, a pulmonary embolism can cause sudden onset of chest pain and shortness of breath, which might be confused with TOS symptoms, especially if there's associated arm pain.
- Aortic dissection: This is a life-threatening condition where the inner layer of the aorta tears, causing severe chest pain that can radiate to the back or arm, potentially mimicking TOS.
- Pancoast tumor: A type of lung cancer located at the top of the lung, which can cause shoulder and arm pain due to invasion of the brachial plexus, mimicking TOS.
- Rare Diagnoses
- Arteriovenous malformation (AVM) or other vascular anomalies: Rare vascular abnormalities in the thoracic outlet could cause symptoms similar to TOS due to abnormal blood flow.
- Tumors compressing the thoracic outlet: Although rare, tumors such as schwannomas or other soft tissue tumors could compress the nerves or vessels in the thoracic outlet, leading to TOS-like symptoms.
- Raynaud’s phenomenon: A condition that affects blood flow to the fingers and toes, and sometimes the ears, nose, and lips, which could be considered in the differential for vascular TOS.