Neurovascular syndromes of the shoulder girdle and upper extremity: the compression disorders and the shoulder-hand syndrome.

Introduction Some of the most perplexing and difficult musculoskeletal disorders are included among those affecting the shoulder girdle and upper extremity. Pain, paresthesias, hyperesthesia and vasomotor disturbances may occur in any of them, but these symptoms in combination are characteristic of few, chiefly the neurovascular syndromes. The interpretation and differentiation of the clinical features may embrace a large number of diseases and disorders (Table I). The purpose of this paper is to summarize present knowledge of two groups of these conditions-the reflex neurovascular disorders, as fully exemplified by the shoulder-hand syndrome, and the compression neurovascular syndromes (' thoracic outlet syndromes '). Since anatomic factors are of basic importance in the genesis of these disturbances, the pertinent anatomy must be visualized in these problems (Fig. i).