Scale syndrome

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Classification according to ICD-10
G54.0 Lesions of the brachial plexus, including thoracic outlet syndrome
ICD-10 online (WHO version 2019)

The Scalenus syndrome ( Thoracic outlet syndrome ) is the painful compression of the arm nerve plexus ( brachial plexus ) by narrowing the scalenus gap . The scalenus gap between the scalenus anterior and medius muscles can be severely narrowed by a cervical rib , by muscle hypertrophy and by a steep position or exostosis of the first rib. This compresses the strands of the brachial plexus and the subclavian artery . A neck rib can also be represented by a band, which can also lead to compression.

Symptoms

Scalenus syndrome is characterized by pain radiating into the arm (especially on the ulnar side of the hand and forearm) and circulatory disorders due to mechanical irritation of the sympathetic plexus of the subclavian artery. In the advanced stage, nerve damage and thus paralysis of the muscles of the little finger can occur. The narrowing of the subclavian artery can cause the smallest blood clots (micro- emboli ) to form and block the finger vessels .

therapy

By introducing local anesthetics ( local anesthetics ) into the tense scalene muscles and avoiding pain-inducing or aggravating stress, the pain can be alleviated. An existing cervical rib or exostoses of the first rib can in severe cases be removed in an operation. Muscle hypertrophy can be treated by surgical splitting of the corresponding muscles.

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