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Thoracic outlet syndrome in Ehlers-Danlos patients as displayed by magnetic resonance imaging, angiography and venography


Thoracic outlet syndrome in Ehlers-Danlos patients as displayed by magnetic resonance imaging, angiography and venography



FASEB Journal 17(4-5): Abstract 469



ISSN/ISBN: 0892-6638

Ehlers-Danlos Syndrome (EDS) is an inherited connective tissue disorder characterized by skin extensibility, joint hypermobility, and tissue fragility. Multiple types exist. Patients develop round shoulders from laxity of the sling/erector muscles. The clavicle and subclavius muscle rotate posteriorly, compressing the bicuspid valves within the internal jugular, external jugular and subclavian veins. This decreases venous return, and triggers TOS symptoms: numbness and tingling of the extremities, headache, ear swooshing and ringing, visual floaters, syncope, nausea, pain in the jaw, shoulder, chest wall, back, groin, coccyx. Shoulder hypermobility enhances costoclavicular compression and triggers above symptoms, the result of increased intracranial, intrathoracic and intraabdominal pressures. Eight patients with EDS were imaged on a 1.5T GE Signa, with 5.8 software, 4.0mm thickness, and saline waterbags alon-side the neck to enhance signal-to-noise ratio. T1 weighted coronal, transverse, oblique, sagittal, coronal abduction external rotation, selected Fast Spin Echo, and 2D Time of Flight sequences were obtained. Bilateral brachial plexus MRI, MRA/MRV displayed venous compression and compression of the neurovascular bundles from laxity of the shoulder girdles in these patients. This presentation displays costoclavicular compression of the venous drainage in three of these patients.

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Accession: 035950799

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