I’ve been diagnosed with TOS and have heard from several people that it is not uncommon for people to have both TOS and ES. I am attaching my dental panoramic X ray and want to know if I should pursue this avenue of diagnosis as well. If someone can shed some light, it would be helpful. The symptom overlap between these two conditions makes it difficult to rule out. I think I know where the styloid processes are but unsure how to measure if it’s possible without being a radiologist or oral surgeon/dentist. Thanks everyone!
@Mitchmunchies - I’ve annotated your pano x-ray so you can see your styloids. Actually what the situation looks like to me is, you have either shorter than normal or normal length styloids then a gap & a section of calcified stylohyoid ligament on each side. The right section of calcified ligament is thicker than the left but there’s a bigger gap between styloid & the left calcified ligament. They aren’t excessively long, but they are both significantly angled inward. You’ll need to get a CT w/ contrast to determine whether or not they are causing any vascular compression.
Thank you so much! Based on what I’ve read online that is what I thought but I have very little experience in this so I really appreciate it!!! They did look angled to me too. I will definitely explore this avenue. Why do ligaments calcify?
Here is my story in case it helps anyone (sorry long!) I have bilateral cervical ribs which are extra ribs on my neck at C7. I didn’t know this until my journey. I got into a MVA in June 2024. I had done physio since my accident and initially had extreme swelling on my lateral right neck and upper trape and extreme stiffness at my neck and bilateral trapes. I got a whiplash diagnosis. At the end of the day at work, unfortunately most of my work is at a desk, I would need to lie down because it felt like my neck and shoulders were tired from keeping my head up. I also had anterior shoulder pain and upper deltoid pain.
Fast forward to today. I still have symptoms and although the tightness has gone done from weekly work from physio and massage, my symptoms seem to be increasing in numbers. My physiotherapist has finally said that no doubt that I have thoracic outlet syndrome but I wonder about Eagle syndrome as well.
Unfortunately, it looks like most symptoms overlap with TOS and ES and I will only list some since I have a large array of them:
Raynaud’s
Red fingers and toes when it is hot outside and I’m physically moving.
Migraines my entire life
Now clicking of my jaw
A clicking noise when I bend my ear to my shoulders on the left lateral neck
When I sing, my voice gets hoarse and strained like someone is choking me
Feeling of blood pressure inflating on my upper right arm
Tunnel vision, unsure if occurring with my migraines but definitely more likely to occur at end of day
Migraines can be caused by Vascular ES, so it’s a good idea if you’re able to get a CT with contrast as @Isaiah_40_31 suggests - timed to show both the arteries and veins to check both. Hoarse voice and feelings of being choked can be ES too. The facial nerve and the trigeminal nerves are commonly affected, where do you experience the allodynia? And the spinal accessory nerve can cause pain and weakness in the arms, shoulders & traps if that’s being compressed or irritated. Some members have had visual disturbances with VES too… But obviously arm & shoulder issues to overlap with TOS like you said.
It’s certainly worth getting the CT done to explore ES…
