Imaging and diagnostic tests used for TOS include which of the following?

• A. MRI
• B. CT
• C. X-ray
• D. All of the above

Answer: (D)

Imaging for thoracic outlet syndrome relies on a set of tests that together map the outlet from bone, soft tissue, and neural perspectives. X-ray is a good first look to spot bony causes such as a cervical rib or first rib anomalies. CT provides superior detail of the bone and its spatial relationships, often with 3D reconstructions to understand how the outlet sits in relation to the clavicle and first rib, which helps in planning treatment. MRI targets the soft tissues and nervous elements, showing scalene muscle changes, fibrous bands, and any compression of the brachial plexus that underlies neurogenic symptoms. When vascular involvement is suspected, vascular-focused studies like Doppler ultrasound or MR/CT angiography are used to assess arterial or venous flow during provocative positions. Since each modality adds distinct information, using all of them gives the most complete evaluation. All of the above is the best choice.