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Thoracic Outlet Syndrome specialist?

I've been battling what appears to be TOS. Right now we aren't conclusive on whether it's arterial or neurogenic. I need a specialist in the issue that practices in the DFW TX area, preferably closer to Fort Worth than Dallas, but I'm running out of time and already lost my job over it, next comes the house. I had a dozen dang MRI's, all unremarkable for degenerative changes to the structures of my spine both soft and hard, atleast at the level of where the numbness would be coming from. Every time we order an MRI it's for a section of spine, my assumption is the radiologist is overlooking elsewhere and only identifying issues (if any) for the spinal section the MRI was ordered for. I had an EMG, a little more painful than the MRI's but still no answers. I've seen two chiropractors, two orthopedic surgeons, two physical therapists and most recently the neurologist for the EMG. I'm getting nowhere fast and running out of time for insurance coverage. I know it's stupid to self diagnose based on the internet's questionable validity but all the symptoms fit and the other day my chiropractor did a Rides(no idea how to spell it, couldn't find specifics) test. It was a test of pulse in both arms at various positions both relaxed and exaggerated. Left arm showed significant restriction when in a self supported above head test. I read TOS can come from auto accidents, which I was in one about four years ago and a combined head on collision impact of about 85mph. Also the most significant symptom commonality was the numbness/tingling in the ring and pinky fingers most common in the early morning hours right before/after waking up. This nailed it on the head because the only time it would ever be numb was right as I was waking up, it was often what woke me up. So, long story short, this is the only real diagnosis that gives any real answers. Now I need a specialist to give me some hard evidence or some relief. Chiro is against surgery, neuro RX'd Neurontin which I found to be no fun, ortho hasn't returned call for a CT, so I'm moving on to a new doctor that won't dismiss me as just out of shape or pressure point irritation. If you don't know a specific doctor that would be best for the situation, atleast tell me which specialty to address the issue to. Ortho? Neuro? maybe Cardio? Any thing, I'm out of ideas and tired of being ignored. I appreciate the answers. I already found the Barnett tower shortly after writing this question, so I greatly appreciate the source info. I failed to mention I'm only 21, so I refuse to accept my body is just getting old because I should be moving in to my prime...not out of it. Thanks again.

Asked By: S T - 10/13/2008
Best Answer - Chosen by Asker
If there is a change in your pulse and you have been ruled out for having a cervical rib, I would seek the advise of a vascular surgeon. I would start looking at vascular causes at this point. An MRA (not MRI) or angiography might be required.
Answered By: mistify - 10/13/2008
Additional Answers (1)
You are obviously an intelligent person. So I believe you could wade through some medical journal articles. This would help you to educate yourself as to the fact that TOS is a very controversial diagnosis and has even more controversy when it comes to treatment... More
Source(s):
Answered By: Joy S - 10/13/2008
 
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