“Clavicular duplication causing thoracic outlet obstruction”: Unique presentation of unreported association between clavicular duplication and thoracic outlet syndrome

Abstract

There are only few reports of clavicular duplication in the literature and all authors have agreed that duplicated clavicles are clinically insignificant. This is the first report of this unique association. A 22‑year‑old female student reported with features of neurogenic thoracic outlet syndrome mainly involving C8‑T1 components of the brachial plexus, seemingly originating from involvement in costo‑clavicular space. Radiograph of the shoulder revealed clavicular duplication. Neuro‑physiological studies corroborated the diagnosis. Patient responded well to conservative treatment and was in follow‑up for 1 year. Radiograph of the shoulder should be included in the workup of neurogenic thoracic outlet syndrome and anomalies of clavicle should be looked into and ruled out along with other common causes. Patient and symptom directed approach with dedicated physiotherapy and occupational therapy is required for optimum outcome.

Keywords: Bifid clavicle, Clavicular duplication, Neurogenic thoracic outlet syndrome, Thoracic outlet syndrome