Table 1.

History and examination features in ATOS, VTOS, and NTOS.

TOS Subtype	History	Examination
ATOS	Claudication/rest pain of upper limb, excluding shoulder/neck Numbness, coolness, pallor	Raynaud’s phenomenon Upper limb ischaemia, digital ulceration, peripheral embolisation Pulsatile mass ± bruit on auscultation Blood pressure differential >20 mmHg Positive EAST, ULTT, Adson’s test
VTOS	Deep pain on movement or rest pain in upper limb, chest, shoulder Swelling and cyanotic discoloration	Upper limb swelling Cyanosis Positive EAST, ULTT, Adson’s test
NTOS	Pain in neck, trapezius, shoulder, arm, chest, occipital headache Variable pattern upper limb weakness, numbness, paraesthesias	Tenderness on palpation: scalene triangle, subcoracoid space Upper plexus (C5-C7): sensory disturbance of arm. Weakness/atrophy of deltoid, biceps, brachialis Lower plexus (C8-T1): sensory disturbance ulnar forearm & hand. Weakness/atrophy of small muscles of the hand, weak wrist & finger flexion Positive EAST, ULTT, Adson’s test