Nine-year Follow-up of a Patient with Thoracic Outlet Syndrome and Paget-Schroetter Syndrome.

Thoracic outlet syndrome (TOS) is a challenging clinical condition with regards to its diagnosis and treatment. Its management may turn out to be challenging a case when an adverse complication such as Paget-Schroetter syndrome (PSS) also co-exists. Herein, we report a nine-year follow-up of a patient with TOS (a 41-year old cardiovascular surgeon) who had suffered multiple PSS episodes and repeat TOS surgeries. In essence, we want to highlight the diverse clinical indings of TOS and discuss its management in light of the relevant literature.

Hand strengths in carpal tunnel syndrome.

The purpose of this study was to determine whether a measurable decrease in isokinetic (dynamic) and isometric (static) hand strengths occurs in carpal tunnel syndrome (CTS) patients. Eighteen CTS patients and 20 healthy controls were included in the study. Isokinetic (eccentric and concentric) and isometric grip and pinch strengths were measured with a Biodex System 3 dynamometer (Biodex Medical System, Inc. New York). All strength measurements, except isometric and isokinetic (concentric/eccentric) three-point pinch and isokinetic (concentric) tip pinch, revealed statistically significant differences between CTS patients and controls. Measurable decrease in hand strengths may exist in CTS despite normal manual assessments. Although both isokinetic (dynamic) and isometric (static) dynamometers are capable of detecting this decrease, neither technique seems better than the other.

A reappraisal on the management of lumbosacral plexopathies in gynecological malignancies: where do the physiatrists stand?

Two patients are reported here with gynecological malignancies--an ovarian and a cervical carcinoma--who had suffered from lumbar plexopathies during their follow-up. Their management is discussed with an emphasis on the collaboration of the gynecologists and the rehabilitation physicians.

Quantification of the weakness and fatigue in thoracic outlet syndrome with isokinetic measurements.

OBJECTIVES: Patients with thoracic outlet syndrome (TOS) complain of many subjective symptoms that are difficult to measure and quantify. In this study we have tried to assess the weakness (muscle strength) and fatigue (endurance) of these patients with an objective measurement method, isokinetic muscle testing. METHODS: Twenty three TOS patients and 15 age matched healthy controls were enrolled in the study. Detailed histories of the patients were taken and the patients underwent complete physical examinations. Cervical radiographies, Doppler ultrasonography, electromyography, and isokinetic measurements were carried out. The isokinetic measurements were carried using the Biodex System 3 dynamometer during concentric shoulder flexions and extensions at velocities of 60 degrees /s, 180 degrees /s, and 240 degrees /s. RESULTS: Although the muscle strengths of both groups seemed to be similar, the fatigue ratios of TOS patients at 60 degrees /s and 180 degrees /s were found to be higher compared with those of healthy controls (p = 0.029, p = 0.007). CONCLUSIONS: TOS patients were found to have muscular performance similar to controls, but their upper extremities developed fatigue more easily than those of healthy individuals.