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[edit | edit source]
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[edit | edit source]
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[edit | edit source]
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[edit | edit source]
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:
See Also[edit | edit source]
- Thoracic Outlet Syndrome
- Subclavian Artery
- Physical examination
- X-ray
- Computed Tomography (CT) scan
- Magnetic Resonance Imaging (MRI)
- Nerve conduction study
- Electromyography (EMG)
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Contributors: Prab R. Tumpati, MD