Thoracic Outlet Syndrome: the culprit du jour?

Fig 2

You may already know, if you've been reading lately, that I recently found out I have atrophy in my dominant hand. My spine & pain doc is quite concerned about this (as well as the rather rapid overall degeneration of both cervical and lumbosacral spine, parasthesia & radiculopathy in all four limbs, and sudden increase in numbness and weakness of extremities, particularly finger grip, which is completely gone in several fingers). I'm slated for a new MRI series, full spine with and without contrast, as well as a quadrilateral EMG nerve study (my last one was just the right arm and leg in early 2010).

As you may imagine, I've had all sorts of fears about what may be causing the sudden decline, particularly this unexpected atrophy in my hand. I know it is not from disuse. Nerve compression is a likely candidate, but fears of a degenerative neuromuscular disease have been haunting me. I may have found a likely culprit. Or at least a guilty co-conspirator. I have Thoracic Outlet Syndrome, with an elongated C-7 transverse process, lordosis (reversal of natural cervical curvature, causing a forward thrust position and CCI), and Brachial Neuritis, Raynaud's (among other related things you'll find on the Life in POTSville page here).

Figure 2 from this article mentions (lower right corner of the diagram) that hand atrophy, while rare, can occur. The article also discusses the lordosis contribution, as well as the C-7 transverse process issue, which is no shock.

Seeing it all tied together along with the possibility of hand atrophy with bilateral paresthesia, worse on the dominant side (true), along with a particular numbness and loss of use of the pinky and ring fingers (again, true) makes me feel oddly comforted…we have a perp to throw in a line up.

With my cervical issues, neuropathy and Ehlers Danlos, among others, Thoracic Outlet Syndrome may not have acted alone. But I am convinced now that it must be playing a significant role. It could even be the ringleader. I also have the loss of pulse (have passed out) and motor weakness.

C-7 transverse process elongated

C-7 transverse process elongated

I will have to bring the article and my theories to my doc to discuss after the EMG. At least now I feel a bit empowered, which is better than sulking and scared. Now, I feel ready to fight like the Zebra I am!

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