Which statement best distinguishes cervical radiculopathy from neurogenic thoracic outlet syndrome?

• A. Cervical radiculopathy tends to follow dermatomal patterns.
• B. Neurogenic thoracic outlet syndrome always presents with vascular signs.
• C. Traction provides permanent relief in discogenic radiculopathy.
• D. Degenerative changes show osteophytes and endplate sclerosis with a soft tissue mass.

Answer: (A)

Cervical radiculopathy presents with sensory changes that map to a specific cervical dermatome, reflecting irritation or compression of a particular nerve root. That dermatomal pattern is the clue that the problem originates at the spinal nerve root rather than within the brachial plexus itself. Neurogenic thoracic outlet syndrome, on the other hand, involves the brachial plexus at the thoracic outlet and often yields symptoms that do not respect a single dermatomal distribution; the spread of pain, numbness, or weakness can be more diffuse and variable with arm position. This difference in distribution is the key way to distinguish the two conditions clinically.

The statement about vascular signs is not reliable for neurogenic TOS, since vascular symptoms point to venous or arterial TOS rather than the neurogenic subtype. Traction relief being permanent is not a consistent or defining feature of discogenic radiculopathy, and imaging findings like osteophytes and sclerosis with a soft tissue mass are nonspecific and can appear in various neck pathologies, not as a distinguishing feature between radiculopathy and neurogenic TOS.