Positions used for thoracic outlet syndrome assessment include which set?

• A. 90 degree, 180 degree, pledge, stick-up
• B. Supine, prone, standing, sitting
• C. Trendelenburg positions
• D. Forked arms and twist

Answer: (A)

Testing for thoracic outlet syndrome relies on provocative arm positions that narrow the thoracic outlet and load the neurovascular bundle as it passes between the clavicle and first rib. The set of positions used includes an arm abducted at the side with the elbow flexed, an arm raised overhead, and two additional poses nicknamed “pledge” and “stick-up” that place the shoulder girdle in different directions to further compress the outlet. These maneuvers reproduce symptoms if there is compression, helping identify involvement of the neurovascular structures and the likely site of compression. Other options describe general body positions or unrelated tests, so they do not comprise the standard provocative maneuvers for TOS assessment.