Scientific/Clinical Article| Volume 19, ISSUE 4, P410-420, October 2006

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An Evidence-based Review of Magnetic Resonance Angiography for Diagnosing Arterial Thoracic Outlet Syndrome

  • Susan Klingaman Estilaei
    Correspondence and reprint requests to Susan K. Estilaei, PT, DPT, OCS, University of California San Francisco, Physical Therapy Faculty Practice, Department of Physical Therapy and Rehabilitation Sciences, Box 0736, San Francisco, California 94143
    Department of Physical Therapy and Rehabilitation Science, UCSF/SFSU Graduate Program in Physical Therapy, San Francisco, California
    Search for articles by this author
  • Nancy N. Byl
    Department of Physical Therapy and Rehabilitation Science, UCSF/SFSU Graduate Program in Physical Therapy, San Francisco, California
    Search for articles by this author


      Arterial thoracic outlet syndrome (TOS) can be difficult to diagnose clinically. Recently, Magnetic Resonance Angiography (MRA) has been used to assist in the diagnosis of arterial TOS. The purpose of this article is to survey the current literature to establish the evidence for or against the use of MRA in the diagnosis of arterial TOS. The evidence-based search was conducted using PubMed, PEDro, Hooked on Evidence, EBM Journals, Ovid, Cochrane, and E medicine. The studies were graded as to the strength of recommendation and to the actual level of evidence. Statistics were calculated when sufficient data were present. The search yielded a total of seven studies. The studies received grades of recommendation that ranged from B to D. The current evidence in support of MRA as a valid test for diagnosing arterial TOS is weak and studies are not based on strong design.
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      JHT Read for Credit

      Quiz: Article #043

      Record your answers on the Return Answer Form found on the tear-out coupon at the back of this issue. There is only one best answer for each question.
      • #1.
        The incidence of TOS seems to be:
        • a.
        • b.
        • c.
        • d.
      • #2.
        The purpose of the article was to examine the literature supporting evidence for the use of
        • a.
          MRA in diagnosing all forms of TOS.
        • b.
          MRA in treating all forms of TOS.
        • c.
          MRA in diagnosing arterial type TOS.
        • d.
          MRA in treating arterial type TOS
      • #3.
        Which type of TOS is most prevalent?
        • a.
        • b.
          disputed neurogenic
        • c.
        • d.
      • #4.
        In cadaveric studies, researchers found what incidence of TOS type anomalies? A range of about:
        • a.
        • b.
        • c.
        • d.
      • #5.
        The article suggests that the evidence for diagnosing arterial TOS with MRA is
        • a.
        • b.
          not compelling.
      When submitting to the HTCC for recertification, please batch your JHT RFC certificates in groups of three or more to get full credit.