<prompt> Which is not true about thoracic outlet syndrome:Radial Nerve is commonly affectedNeurological features are most common.Resection of 1st rib relieves symptomPositive Adsons test  <response>: Ans is a ie Radial Nerve is commonly affected Ref. S. Das text book of Surgery, 4e, p 170Not the Radial nerve, but ulnar nerve is most commonly affected in thoracic outlet syndrome.Thoracic Outlet Syndromeis the collective name which includes -Cervical rib syndromeScalenus anterior syndrome Costoclavicular syndromeHyperabduction syndromePectoralis minor syndromeFirst thoracic rib syndromeThe syndrome is caused by compression of the brachial plexus or subclavian vessels in the region of thoracic outlet. The symptoms may arise from neural, vascular or combined compression.Neurological symptoms are more commonCompression of the brachial plexus usually affect its lower trunk C8 T1Symptoms are - Pain, Paraesthesia and numbness usually in the finger and hands in the ulnar nerve distribution.Symptoms of Arterial Compression are seen less frequently in about 14 of the cases.Symptoms are - Pain, numbness, paresthesia, coldness and weakness of the arm or hand. Raynauds phenomenon may also occur.Venous symptoms are less common and include edema, venous distention, pain and cyanosis.Diagnostic tests or man oeuvres :Adsons testCostoclavicular compressive testHyperabduction test. Treatment:Before surgical management conservative tt is given a trialConservative Mx - Weight reduction, Exercise Programme.Operative management differs according to the pathology causing thoracic outlet obstructionExcision of 1st rib in First thoracic rib syndrome.Excision of cervical rib in cervical rib syndrome.Scalenotomy Scalenus anticus syndrome.Division of pectoralis minor Pectoralis minor syndrome. 