Why might I need a thoracic outlet ultrasound?
Thoracic outlet syndrome can cause a range of symptoms involving the shoulder, arm or hand.
Symptoms may include:
- pain or discomfort in the shoulder or arm
- numbness or tingling
- weakness or heaviness in the arm
- arm swelling
- changes in colour or temperature of the hand or arm
- symptoms that become worse when the arm is raised or held in certain positions.
Some people notice symptoms during activities that require the arms to remain elevated, such as drying their hair, working overhead, exercising or performing repetitive arm movements.
Your GP or specialist may request a thoracic outlet ultrasound when vascular thoracic outlet syndrome is suspected.
What does a thoracic outlet ultrasound assess?
The ultrasound examines the arteries and veins around the shoulder and thoracic outlet, including the vessels as they pass beneath the clavicle.
The sonographer uses B-mode, colour Doppler and pulsed-wave Doppler ultrasound to assess blood flow at rest and during a series of controlled arm movements.
These may include:
- the arm raised to approximately 90 degrees
- further arm elevation or abduction
- other standard provocative positions used during the examination.
The purpose is to identify whether particular positions produce changes in arterial or venous blood flow that may be consistent with vascular compression.
If you know that a particular movement or arm position reliably reproduces your symptoms, please tell the sonographer. Where appropriate and technically possible, they may assess blood flow while reproducing that position.
Not every symptomatic position can be examined reliably with ultrasound, and ultrasound findings form only one part of the overall clinical assessment of thoracic outlet syndrome.
What happens during the test?
No special preparation is usually required.
Please arrive approximately 5 minutes before your appointment to allow time for any necessary paperwork.
You will need to ensure the neck, shoulder and upper arm areas are accessible. The sonographer will advise you if any clothing needs to be removed or adjusted.
During the examination you will usually sit on the edge of the examination bed while the sonographer assesses the arteries and veins around the neck, shoulder and upper arm.
Ultrasound gel is applied to the skin and the probe is moved gently across the area while blood-flow measurements are recorded.
You will then be asked to move your arm through several positions so changes in blood flow can be assessed.
If any position is uncomfortable or you are unable to perform a particular movement, please tell the sonographer.
How will I receive my results?
Following the examination, the ultrasound images and blood-flow measurements are reviewed and a report is prepared.
If you are seeing Dr Igor Banzic on the same day as your scan, he can discuss the findings with you during your consultation.
Otherwise, the report will be sent to your referring GP or specialist, who can discuss the results and any appropriate next steps with you.
If an urgent finding is identified, this will be communicated promptly to the appropriate doctor.
