{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,9]],"date-time":"2026-09-09T04:50:54Z","timestamp":1788929454515,"version":"build-2803163510"},"reference-count":38,"publisher":"SAGE Publications","issue":"8","license":[{"start":{"date-parts":[[2023,7,31]],"date-time":"2023-07-31T00:00:00Z","timestamp":1690761600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"name":"The Foundation for Barnes Jewish Hospital, BJC Healthcare, St. Louis, MO","award":["Thoracic Outlet Syndrome Research and Education Fu"],"award-info":[{"award-number":["Thoracic Outlet Syndrome Research and Education Fu"]}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Hand (New York, N,Y.)"],"published-print":{"date-parts":[[2024,11]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Spontaneous shoulder-girdle pain and scapular winging\/dyskinesis can be caused by several neuromuscular disorders identifiable by electrodiagnostic studies (EDX). We describe a group of adolescent athletes with this clinical presentation but normal EDX, followed by later development of neurogenic thoracic outlet syndrome (NTOS).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>We identified patients referred for evaluation of NTOS that had a history of chronic atraumatic shoulder-girdle pain, scapular winging\/dyskinesis, and normal EDX. Each was refractory to conservative management and underwent supraclavicular decompression and brachial plexus neurolysis for NTOS. Functional disability was quantified by Quick Disabilities of the Arm, Shoulder, and Hand (QuickDASH) scores.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>There were 5 female patients with a mean age at symptom onset of 14.2 \u00b1 0.4 years, including spontaneous severe pain in the shoulder, scapula, and arm, along with prominent scapular winging\/dyskinesis, and normal EDX. Symptoms had persisted for 18.9 \u00b1 4.0 months prior to referral, with pronounced upper extremity disability (mean QuickDASH, 54.6 \u00b1 6.9). By 3 months after surgical treatment for NTOS, all 5 patients experienced near-complete symptom resolution, including scapular winging\/dyskinesis, with markedly improved function (mean QuickDASH, 2.2 \u00b1 1.3) and a return to normal activity.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>A subset of patients with chronic atraumatic shoulder-girdle pain, scapular winging\/dyskinesis, and normal EDX may develop dynamic brachial plexus compression characteristic of NTOS, exhibiting an ischemic \u201cSunderland-zero\u201d nerve conduction block for which surgical decompression can result in rapid and substantial clinical improvement. The presence of surgically treatable NTOS should be considered for selected patients with long-standing scapular winging\/dyskinesis who fail conservative management.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/15589447231187088","type":"journal-article","created":{"date-parts":[[2023,7,31]],"date-time":"2023-07-31T07:28:37Z","timestamp":1690788517000},"page":"1206-1213","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":2,"title":["Rapid Functional Recovery After Thoracic Outlet Decompression in a Series of Adolescent Athletes With Chronic Atraumatic Shoulder-Girdle Pain, Scapular Winging\/Dyskinesis, and Normal Electrodiagnostic Studies"],"prefix":"10.1177","volume":"19","author":[{"given":"Jackson S.","family":"Burton","sequence":"first","affiliation":[{"name":"Washington University in St. Louis, MO, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5561-6027","authenticated-orcid":false,"given":"Susan E.","family":"Mackinnon","sequence":"additional","affiliation":[{"name":"Washington University in St. Louis, MO, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"suffix":"IV","given":"Paul B.","family":"McKee","sequence":"additional","affiliation":[{"name":"University of Louisville, KY, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karen M.","family":"Henderson","sequence":"additional","affiliation":[{"name":"Washington University in St. Louis, MO, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Danita M.","family":"Goestenkors","sequence":"additional","affiliation":[{"name":"Washington University in St. Louis, MO, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2609-1284","authenticated-orcid":false,"given":"Robert W.","family":"Thompson","sequence":"additional","affiliation":[{"name":"Washington University in St. Louis, MO, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2023,7,31]]},"reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhsa.2018.08.008"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1002\/mus.26059"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jse.2021.02.012"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1093\/brain\/awh722"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1002\/mus.25008"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1136\/jnnp-2020-323164"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.1097\/WCO.0000000000000968"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.1097\/PHM.0b013e3181a5b980"},{"key":"e_1_3_2_10_2","doi-asserted-by":"publisher","DOI":"10.1067\/msg.2002.127926"},{"key":"e_1_3_2_11_2","doi-asserted-by":"publisher","DOI":"10.1007\/s40122-019-0124-2"},{"key":"e_1_3_2_12_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.thorsurg.2020.09.005"},{"key":"e_1_3_2_13_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvs.2016.04.039"},{"key":"e_1_3_2_14_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvs.2017.03.419"},{"key":"e_1_3_2_15_2","first-page":"67","volume-title":"Thoracic Outlet Syndrome","author":"Thompson RW","unstructured":"Thompson RW. Diagnosis of neurogenic thoracic outlet syndrome: 2016 consensus guidelines and other strategies. In:Illig KA, Thompson RW, Freischlag JA, et al. eds, Thoracic Outlet Syndrome. 2nd ed. Cham: Switzerland: Springer Nature; 2021:67-97.","edition":"2"},{"key":"e_1_3_2_16_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejvs.2021.02.048"},{"key":"e_1_3_2_17_2","doi-asserted-by":"publisher","DOI":"10.1002\/mus.27395"},{"key":"e_1_3_2_18_2","doi-asserted-by":"publisher","DOI":"10.1097\/SAP.0000000000003053"},{"key":"e_1_3_2_19_2","first-page":"59","volume-title":"Nerve Surgery","author":"Ferrante MA","unstructured":"Ferrante MA, Wilbourn AJ. The electrodiagnostic examination with peripheral nerve injuries. In: Mackinnon SE, ed. Nerve Surgery, New York, NY: Thieme; 2015:59-74."},{"key":"e_1_3_2_20_2","volume-title":"Electromyography and Neuromuscular Disorders: Clinical-Electrophysiologic-Ultrasound Correlations","author":"Preston DC","year":"2021","unstructured":"Preston DC, Shapiro BE, eds. Electromyography and Neuromuscular Disorders: Clinical-Electrophysiologic-Ultrasound Correlations. 4th ed. Philadelphia, PA: Elsevier; 2021.","edition":"4"},{"key":"e_1_3_2_21_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhsa.2022.04.008"},{"key":"e_1_3_2_22_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvs.2018.12.027"},{"key":"e_1_3_2_23_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.avsg.2021.09.048"},{"key":"e_1_3_2_24_2","first-page":"265","volume-title":"Thoracic Outlet Syndrome","author":"Thompson RW","unstructured":"Thompson RW, Ohman JW. Surgical techniques: operative decompression using the supraclavicular approach for neurogenic thoracic outlet syndrome. In: Illig KA, Thompson RW, Freischlag JA, et al. eds. Thoracic Outlet Syndrome. 2nd ed. Cham, Switzerland: Springer Nature; 2021:265-285.","edition":"2"},{"key":"e_1_3_2_25_2","first-page":"399","volume-title":"Thoracic Outlet Syndrome","author":"Henderson KM","unstructured":"Henderson KM, Najrabi F, Robinson MN, et al. Neurogenic TOS: early postoperative care. In: Illig KA, Thompson RW, Freischlag JA, et al. eds. Thoracic Outlet Syndrome. 2nd ed. Cham, Switzerland: Springer Nature; 2021:399-404.","edition":"2"},{"key":"e_1_3_2_26_2","first-page":"415","volume-title":"Thoracic Outlet Syndrome","author":"Earley JA","unstructured":"Earley JA, Pate C. Rehabilitation after first rib resection. In: Illig KA, Thompson RW, Freischlag JA, et al. eds. Thoracic Outlet Syndrome. 2nd ed. Cham, Switzerland: Springer Nature; 2021:415-424.","edition":"2"},{"key":"e_1_3_2_27_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvs.2012.07.025"},{"key":"e_1_3_2_28_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0749-8063(03)00389-X"},{"key":"e_1_3_2_29_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.avsg.2010.02.022"},{"key":"e_1_3_2_30_2","first-page":"137","volume-title":"Thoracic Outlet Syndrome","author":"Thompson RW","unstructured":"Thompson RW. Pectoralis minor syndrome. In: Illig KA, Thompson RW, Freischlag JA, et al, eds. Thoracic Outlet Syndrome. 2nd ed. Cham, Switzerland: Springer Nature; 2021:137-143.","edition":"2"},{"key":"e_1_3_2_31_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvs.2012.11.045"},{"key":"e_1_3_2_32_2","doi-asserted-by":"publisher","DOI":"10.1177\/0363546516664720"},{"key":"e_1_3_2_33_2","doi-asserted-by":"publisher","DOI":"10.1186\/s40634-022-00491-x"},{"key":"e_1_3_2_34_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejvs.2022.05.003"},{"key":"e_1_3_2_35_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.avsg.2008.04.017"},{"key":"e_1_3_2_36_2","doi-asserted-by":"publisher","DOI":"10.3171\/2017.7.PEDS17257"},{"key":"e_1_3_2_37_2","doi-asserted-by":"publisher","DOI":"10.1177\/1558944719901319"},{"key":"e_1_3_2_38_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvs.2022.10.002"},{"key":"e_1_3_2_39_2","doi-asserted-by":"publisher","DOI":"10.1093\/brain\/74.4.491"}],"container-title":["HAND"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/15589447231187088","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/15589447231187088","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/15589447231187088","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T07:28:55Z","timestamp":1777447735000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/15589447231187088"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,7,31]]},"references-count":38,"journal-issue":{"issue":"8","published-print":{"date-parts":[[2024,11]]}},"alternative-id":["10.1177\/15589447231187088"],"URL":"https:\/\/doi.org\/10.1177\/15589447231187088","relation":{},"ISSN":["1558-9447","1558-9455"],"issn-type":[{"value":"1558-9447","type":"print"},{"value":"1558-9455","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,7,31]]}}}