Differential diagnosis in patients with possible NTOS

Abstract

Patients in whom the diagnosis of NTOS is being considered usually have neck and arm pain, sensory changes, and weakness that may be exacerbated by certain stress maneuvers. As discussed in Chap. 7, the presence of these features in a patient's history and the reproduction of concordant experiences by bedside examination are two fundamental processes that start the diagnostic process. The diagnostic process then continues with a consideration of entities that simulate NTOS but are, in fact, separate entities. Equally important but often overlooked is the need to recognize certain conditions that commonly coexist with NTOS but are associated with a poor outcome to NTOS-directed therapy ("game changers") and, therefore, require a more dramatic change in the therapeutic approach.