<prompt> Thoracic outlet syndrome is primarily diagnosed byClinical EvaluationCT scanMRIAngiography  <response>: The initial presentation of thoracic outlet syndromeeg.,in cervical ribis dependent on whether the compression is primarily vascular,neurogenic or a combination of both.Vascular thoracic outlet syndrome can involve subclan aery or vein presenting with colour changes of affected upper extremity,claudication,or diffuse pain.Neurogenic syndrome involves brachial plexus presenting as sensory loss,pain or paraesthesia. Reference:Bailey Loves sho practise of surgery,25th edition,pageno:895. 