Oliver's sign

Oliver's Sign is a medical term referring to a clinical sign in which there is a notable decrease or disappearance of the carotid pulse upon raising the patient's arm above their head. This sign is often associated with Thoracic Outlet Syndrome (TOS), a group of disorders that occur when blood vessels or nerves in the space between your collarbone and your first rib (thoracic outlet) become compressed.

Causes

The primary cause of Oliver's Sign is the compression of the Subclavian Artery, which is located beneath the collarbone. This compression can occur due to a variety of factors, including:

• Anatomical defects: Inherited defects such as an extra rib located above the first rib (cervical rib) or an abnormally tight fibrous band connecting your spine to your rib.
• Poor posture: Drooping your shoulders or holding your head in a forward position can compress the thoracic outlet.
• Trauma: A traumatic event, such as a car accident, can cause internal changes that then compress the nerves in the thoracic outlet. The onset of symptoms related to nerve compression may be delayed.
• Repetitive activity: Doing the same thing repeatedly can, over time, wear on your body's tissues.

Symptoms

The symptoms of Oliver's Sign can vary depending on which nerves or blood vessels are compressed. When nerves are compressed, neurological thoracic outlet syndrome can occur, with symptoms such as:

• Muscle wasting in the fleshy base of your thumb (Gilliatt-Sumner hand)
• Numbness or tingling in your arm or fingers
• Pain or aches in your neck, shoulder or hand
• Weakening grip

Diagnosis

Diagnosis of Oliver's Sign and the associated Thoracic Outlet Syndrome can be challenging due to the overlap of symptoms with other conditions. Doctors may use a variety of tests, including:

• Physical examination
• X-ray
• Computed Tomography (CT) scan
• Magnetic Resonance Imaging (MRI)
• Nerve conduction study
• Electromyography (EMG)

Treatment

Treatment for Oliver's Sign and Thoracic Outlet Syndrome can range from physical therapy to surgery, depending on the severity and cause of the symptoms. Treatment options include:

• Physical therapy
• Medications
• Surgical procedures

See Also

• Thoracic Outlet Syndrome
• Subclavian Artery
• Physical examination
• X-ray
• Computed Tomography (CT) scan
• Magnetic Resonance Imaging (MRI)
• Nerve conduction study
• Electromyography (EMG)

Oliver's sign Resources
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