u/Fearless_Page_7916

Hello, I’m confused whether my tests and symptoms rule out any vascular or arterial TOS and whether I should be starting PT for Cubital Tunnel Syndrome.

My symptoms include arm and hand weakness and a hand discolouration and swelling that gets better when arm is raised. My elbow hurts when I bend it, this pain limits me from using my dominant hand to eat, write or doing pretty much anything that requires me bending my arm.

An ultrasound showed that my ulnar nerve is compressed at the elbow. However, doctors weren’t convinced that it’s the source of my symptoms, especially that my hand turns reddish/bluish

I did Doppler and the following is the summary:

All arteries and veins in the right arm show **normal structure and blood flow**, including during tests performed in different positions. There is **no evidence of blood clots or thoracic outlet syndrome**, indicating a normal vascular exam.

Furthermore, my CT scan with contrast showed moderate compression with arms raised, but without the vein collapsing:

The angio-CT (performed both in neutral and raised-arm positions) shows **no significant abnormalities of the thoracic outlet, arteries, or veins**, and no evidence of thrombosis or vascular stenosis. Although there is a **moderate narrowing with mild compression of the right subclavian vein in the raised-arm position**, it is not severe, with no collateral circulation or signs of clinically significant compression.

My hands color gets better when I raise my arm, shouldn’t it be worse if the compression happen when arm is raised?

I’m really confused and there is no TOS specialist in the country where I’m living so I’m not so sure on what I need to do next. I’m stating nerve gliding for ulnar nerve, but unsure whether this will help my arm pain.

Thanks.

My symptoms include arm and hand weakness and a hand discolouration that gets better when arm is raised. My elbow hurt when I bend it.

An ultrasound showed that my ulnar nerve is compressed at the elbow. However, doctors weren’t convinced that it’s the source of my symptoms, especially that my hand turns reddish/bluish

I did Doppler and the following is the summary:

All arteries and veins in the right arm show normal structure and blood flow, including during tests performed in different positions. There is no evidence of blood clots or thoracic outlet syndrome, indicating a normal vascular exam.

Furthermore, my CT scan with contrast showed moderate compression with arms raised, but without the vein collapsing:

The angio-CT (performed both in neutral and raised-arm positions) shows no significant abnormalities of the thoracic outlet, arteries, or veins, and no evidence of thrombosis or vascular stenosis. Although there is a moderate narrowing with mild compression of the right subclavian vein in the raised-arm position, it is not severe, with no collateral circulation or signs of clinically significant compression.

Now I’m curious whether these tests rule out a vascular compression that can contribute to my symptoms or whether the vascular compression is something normal and that the nerves being compressed is the problem (probably being compressed in the thoracic and also at the elbow).

Is PT the treatment of this?

Thanks.

4 hours ago I did CT scan with contrast and after the test, I was dizzy and my face and body had rashes. A nurse took me to a room and injected me with something, I think it was antihistamine, most of the rashes are gone now but I’m still dizzy/confused. I can swallow and I don’t notice any loss of breath.

I never had any allergies before and it was the first time having a test with contrast. Was this a mild-moderate one and how rare is it to happen usually? Also, for the peace of mine, I believe any severe reactions are probably extremely unlikely since it’s been 4 hour?

Thanks!

Will this also check if arteries are being compressed, meaning covering both vTOS and aTOS?

My hand gets discolored but I’d like to disregard vTOS and aTOS so I focus on PT and postural position exercises before jumping to any surgery.

Im scheduled to do CT with contrast while moving my arms, and I already did Ultrasound Doppler with the following results:

“On ultrasound examination, triphasic distal blood flow is observed both with the arms in abduction and in adduction”

Are both CT scan and Ultrasound enough to rule both vTOS and aTOS?