A bizarre issue. Pictures attached. Any help would be appreciated.

[physiobob]

Hi Jason and thanks for your interesting post. It's a bit late where I am right now but let's make a start. You mention weakness. Can you be a little more specific to what seems weak and which actions e.g. arm, hand, shoulder movements. My initial though was also TOS. You cannot really comment on the scan in terms of boney alignment as no one is symmetrical but a rib that is closer to another one (without any birth deformity or injury) could mean that the joint where it attached to the spine could be out of place slightly. Paresthesia and numbness and weakness would point to more nerve involvement but then your EMG studies are normal (shame they were not done when you had more symptoms).

Was there something that you did at the time the symptoms began? Also is there ever any discoloration of the affected arm in comparison to the unaffected arm? I await some of your initial responses and come back to you tomorrow. It could be as simple as a thoracic disc which would not have been found on the MRI of the C-Spine.

Chat again soon

[Jasonm]

Hi Bob. Thanks for the reply. The weakness is more of a general heaviness with overhead movement. If I had to pinpoint it I'd say the shoulder. I did not do anything in particular. I just began having some upper back pain one day and it progressed rapidly. I don't really notice any discoloration of the affected arm. Though the veins are darker on the symptomatic arm and my hand turned colors and became weak during a roo's test.

If I sit upright for a few minutes, my shoulder and neck will tighten and twitch which then causes the TOS like symptoms. The left sided upper back pain is the only constant. If I stretch my neck it feels restricted in the same area.

Would any additional diagnostic tests be helpful? What is the treatmebt for a misaligned thoracic disk?

Please feel free to ask me anything else.