![]() ![]() From here they interchange and extend along the shoulder, the upper arm and forearm distally to the hand and fingers. The brachial plexus is a bundle of nerves originating from the spinal cord, which exit the vertebrae of the cervico-thoracic spine (C5 to T1) and descending along the body to form the brachial plexus. In order to understand this pathology, we provide some anatomical descriptions. It was only years later at the medico-legal examination that TOS was finally identified and treated allowing the patient to regain work capacity. In addition, we will present a specific case study to illustrate the roller coaster of an individual who suffered a significant impairment of the function of the upper limb. In this newsletter together with Mr Thomas Kossmann, who has himself identified several TOS cases in his medico-legal work, we will provide a brief overview of the pathological characteristics of TOS. In compensable circumstances, the condition may also attract a permanent impairment value. With a delayed diagnosis, the patient’s condition may become so severe that a full recovery is unachievable because a sustained TOS can cause irreparable damage to the nerves of the brachial plexus. The treatments offered are often unnecessary, bringing no benefit to patients who frequently develop significant mental health disturbances. TOS patients can be subjected over months or years to unnecessary tests and specialist examinations without a conclusive diagnosis. In fact, the diagnosis of TOS is generally dependent on the clinician’s familiarity with the complexity of TOS, taking into account the symptoms as well as the patient-specific risk factors. TOS is not easy to recognise, diagnose and treat, often resulting in a patient’s prolonged suffering before the condition is finally identified. Thoracic outlet syndrome (TOS) is a critical condition both in medicine and within the medico-legal setting. ![]()
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