A Prospective Evaluation of Duplex Ultrasound for Thoracic Outlet Syndrome in High-Performance Musicians Playing Bowed String Instruments

被引:23
作者
Adam, Garret [1 ]
Wang, Kevin [2 ]
Demaree, Christopher J. [3 ]
Jiang, Jenny S. [4 ]
Cheung, Mathew [5 ]
Bechara, Carlos F. [6 ]
Lin, Peter H. [1 ,5 ]
机构
[1] Baylor Coll Med, Michael E DeBakey Dept Surg, Houston, TX 77030 USA
[2] Univ Southern Calif, Keck Sch Med, Dept Med, Los Angeles, CA 90007 USA
[3] Tulane Univ, Sch Med, Dept Med, New Orleans, LA 70112 USA
[4] Univ Texas MD Anderson Canc Ctr, Dept Med, Houston, TX 77030 USA
[5] Univ Vasc Associates, Los Angeles, CA 90024 USA
[6] Loyola Univ Chicago, Stritch Sch Med, Dept Surg, Maywood, IL 60153 USA
来源
DIAGNOSTICS | 2018年 / 8卷 / 01期
关键词
thoracic outlet syndrome; nerve entrapment syndrome; musician; bowed string instrument; violin; viola; cello; MUSCULOSKELETAL PROBLEMS; COMPRESSION; VIOLINIST; DYSTONIA; PLAYERS;
D O I
10.3390/diagnostics8010011
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Thoracic outlet syndrome (TOS) is a neurovascular condition involving the upper extremity, which is known to occur in individuals who perform chronic repetitive upper extremity activities. We prospectively evaluate the incidence of TOS in high-performance musicians who played bowed string musicians. Sixty-four high-performance string instrument musicians from orchestras and professional musical bands were included in the study. Fifty-two healthy volunteers formed an age-matched control group. Bilateral upper extremity duplex scanning for subclavian vessel compression was performed in all subjects. Provocative maneuvers including Elevated Arm Stress Test (EAST) and Upper Limb Tension Test (ULTT) were performed. Abnormal ultrasound finding is defined by greater than 50% subclavian vessel compression with arm abduction, diminished venous waveforms, or arterial photoplethysmography (PPG) tracing with arm abduction. Bowed string instruments performed by musicians in our study included violin (41%), viola (33%), and cello (27%). Positive EAST or ULTT test in the musician group and control group were 44%, and 3%, respectively (p = 0.03). Abnormal ultrasound scan with vascular compression was detected in 69% of musicians, in contrast to 15% of control subjects (p = 0.03). TOS is a common phenomenon among high-performance bowed string instrumentalists. Musicians who perform bowed string instruments should be aware of this condition and its associated musculoskeletal symptoms.
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页数:9
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