What symptom may indicate thoracic outlet syndrome during the Adson Maneuver?

The Adson Maneuver is a clinical test used to assess for thoracic outlet syndrome (TOS), which often involves the compression of neurovascular structures between the collarbone and the first rib. When performing the Adson Maneuver, the patient is asked to take a deep breath and turn their head toward the tested side while the clinician palpates the radial pulse at the wrist.

Coldness in the upper extremity is a symptom that may indicate thoracic outlet syndrome during this maneuver because it suggests impaired blood flow to the arm. In TOS, the subclavian artery can become compressed, leading to a reduction in blood supply to the upper extremity. This compromised circulation may result in a sensation of coolness, which patients may notice as a lack of warmth or a cold feeling in the arm or hand.

Other symptoms associated with TOS can include pain, numbness, or weakness, but the particular symptom of coldness is particularly indicative of vascular compromise. Recognizing such vascular symptoms is crucial for the diagnosis and subsequent management of thoracic outlet syndrome, making coldness in the upper extremity a key observation during this test.