The use of the emergency department (ED) as a source for primary care
has increased the number of patients seen in this setting with even ch
ronic symptoms such as pain, paresthesias, and weakness in the upper e
xtremity. This group may include individuals with thoracic outlet synd
rome (TOS). We were concerned that TOS may be underdiagnosed in the ED
because of physician unfamiliarity with the signs and symptoms of TOS
. Hence, we retrospectively studied cases of TOS seen at the ED of the
University hospital. during a 29-year period. We believe this is the
first report in the English language literature to reflect the assessm
ent and management of TOS in the ED. The study data include clinical p
resentation, diagnostic tests, and management of TOS. Lack of thorough
evaluation resulted in underdiagnosis of TOS in our ED. We recommend
that ED personnel pay close attention to patients with symptoms of lon
g duration and that ED physicians be aware of TOS presentation and its
management.