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Thoracic Outlet Syndrome: Challenges to Diagnosis of Symptoms Can Prove Detrimental to Car Accident Victims

“In many cases, the challenges to the diagnosis of the symptoms of thoracic outlet syndrome can prove detrimental to car accident victims experiencing severe neck, shoulder, or arm pain or weakness.” 


 --James Ballidis, California injury attorney specializing in thoracic outlet syndrome




Thoracic Outlet Syndrome: The Process of the Diagnosis of Symptoms



“Diagnosis of the symptoms of thoracic outlet syndrome is often a process of elimination, with doctors beginning by ruling out other potential causes,” explained California injury attorney James Ballidis. “Patients may visit a neurologist, a vascular medicine physician and other specialists who can perform necessary testing to identify TOS.” 



Experts from both the Mayo Clinic and Johns Hopkins indicate that a comprehensive physical examination is the first step in diagnosing the condition. The doctor should look for a depression in the shoulder, a limited range of motion and discoloration in the arm. A doctor may also be able to feel the scalene muscles in the neck, which are generally tender. 



Taking a medical history is also essential. The two most common causes of TOS according to the Cleveland Clinic are car accidents and repetitive stress placed on the body, often as a result of work tasks.  While symptoms do not appear immediately after trauma, a history of an auto crash—and especially of whiplash injuries—can be a strong indicator of thoracic outlet syndrome, according to an injury attorney in California. 



Below are some of the tests that may be performed:


  • X-rays and MRIs to assess internal problems or damage such as the presence of an extra bone, broken ribs or compressions of the nerves and blood vessels. 
  • An EMG, which allows a doctor to see how the nerves and muscles are working. 
  • A nerve conduction study, which measures how a nerve conducts impulses to assess nerve damage. 
  • Addison’s maneuver, in which you are asked to turn your head while extending your neck, arm and shoulder away from the body. Your doctor will check your pulse on your extended arm as your head is turned to see if you exhibit TOS symptoms or if your pulse is reduced. If so, this is a positive test result for TOS. 
  • The Wright test, which involves rotating your arm outward while it is held up and backward as you are in a sitting position. Again, your doctor is checking your pulse to see if it is diminished, which can suggest compressed blood vessels and TOS. 
  • The Roos stress test, which involves holding elbows back and at shoulder height while in a sitting position.  As you push your shoulders back, you’ll be asked to open and close your hands several times. If you have TOS, you may feel heaviness in the shoulder, the shoulder may become tired or your symptoms may occur. 




How Difficulties with the Diagnosis of Symptoms Impact Car Accident Victims



The challenges inherent in diagnosing TOS and the absence of objective proof of the syndrome create problems for those who sustain their thoracic outlet syndrome as a result of trauma from a car accident. 



Those responsible for causing accidents are supposed to compensate crash victims fully for all injuries, including TOS.  Unfortunately, insurance companies may try to deny a TOS diagnosis or undervalue losses caused by this condition.  Your injury attorney will have the burden of showing how badly your TOS has harmed you and of proving your damages. The stronger the evidence—including a clear and objective medical test showing you have a given condition—the better the chances of recovering full compensation.



The diagnostic delay can also create problems with the California statute of limitations. You have only a limited period of time to obtain an attorney to pursue a lawsuit after a car accident, and the TOS may not be conclusively diagnosed during the period when you may bring your claim.  You will need to work with a physician and an attorney to estimate an appropriate damage award for compensation for the condition or for the undiagnosed symptoms you are exhibiting. 



Due to the challenges associated with diagnosing TOS, it is imperative to consult an attorney experienced in working with accident victims suffering from this condition to ensure a successful settlement or award for damages. 



Our injury attorneys have established professional relationships with the doctors and specialists necessary to diagnose and treat this painful and debilitating disease. Over nearly forty years practicing law in California, they have obtained successful settlements in numerous TOS cases. 



Additional resources are available to the public free of charge through our office. 



If you would like to request one of these free resources, or to speak with an injury attorney in California, feel free to call 866-981-5596. 

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