Thoracic outlet syndrome is primarily diagnosed by
Clinical Evaluation
CT scan
MRI
Angiography
The initial presentation of thoracic outlet syndrome(eg.,in cervical rib)is 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 & Love's sho practise of surgery,25th edition,pageno:895.
Cardio thoracic surgery  