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Fibrosis and Scarring of the Brachial Plexus as Displayed by MRI/MRA/MRV

Bilateral rounding of the shoulders (laxity) associated with kyphosis of the thoracic spine causes costoclavicular venous compression and brachial plexopathy. This form of thoracic outlet syndrome is usually not amenable to surgical treatment in older patients, particularly in severe kyphosis of the thoracic spine. The objective of this presentation is to display the sites of landmark anatomy compressing the brachial plexus that decreases venous return to the nerves causing a shortage of oxygen and glucose needed for cellular metabolism causing fibrosis and scarring of the soft tissues marginating the brachial plexus. Magnetic resonance imaging (MRI) is the only modality that displays fibrosis and scarring of fascial plane anatomy obstructing venous and lymphatic return, not possible with Ultrasound and/or Computerized Axial Tomography (CAT).