For Health Care Professionals

PATIENT TREATMENT / EVALUATIONS

If you are a physician or other health care professional interested in having us evaluate and/or treat a patient that you think might have any form of TOS, please call Della Brink in our office at 314-362-7410.

DOCTORS ACCESS LINE/ DIRECT REFERRALS

If you are a physician or other health care professional interested in a direct referral for a patient with a more urgent problem, or possible transfer of a patient from another hospital facility or emergency room, please contact Dr. Robert Thompson through the Barnes-Jewish Hospital Doctors Access Line (DAL), at 1-800-252-DOCS.

PATIENT INQUIRIES

If you are a patient interested in visiting for an office evaluation and/or treatment for any form of TOS, please call our office at 314-DOC-4-TOS.

The Washington University Center for Thoracic Outlet Syndrome at Barnes-Jewish Hospital provides high-level consultation and coordinated care to more than 300 patients each year.  Dr. Thompson and his group have had an ongoing interest in the management of all forms of thoracic outlet syndrome for the past 18 years.

We recognize that providing the best care for patients with TOS requires more than just the conduct of surgical procedures. Encompassing a comprehensive, multidisciplinary approach to these rare and challenging clinical conditions, we have developed close interactions with:
 

  • Physical therapists
  • Pain management physicians
  • Diagnostic and interventional radiologists
  • Other specialists

Recognition of our experience in managing all forms of TOS has led to a growing volume of local, regional, and distant referrals. In examining our patient population from the past two years, we find these approximate patient distributions:

  • 40% from the six-county area of metropolitan St. Louis (St. Louis City and County, St. Charles County, and Jefferson County in Missouri; Madison County, St. Clair County and Monroe County in Illinois)
  • 40% from elsewhere in Missouri and Illinois (including Chicago)
  • 20% from other regions of the United States, including California and other Western States, the East Coast, Texas, and Florida

We also care for patients of all ages, including those in their teenage years. We are extremely grateful to the many referring physicians, surgeons, physical therapists, athletic trainers, and others who continue to identify patients with possible TOS, who appreciate the unique focus we have placed on these conditions, and who recognize the importance of our multidisciplinary approach toward providing a special standard of excellence for a challenging group of problems:

Thank you for helping us provide great care for patients with TOS!

As a primary-care physician or specialist caring for a patient with possible TOS, referral to our Center offers a number of distinct advantages including:

  • A wealth of experience and expertise in diagnostic evaluation, including uncommonly performed procedural techniques such as controlled selective scalene/pectoralis muscle blocks and specific radiologic protocols for positional MR angiography
  • The expertise we offer in coordinated physical therapy focused specifically on TOS, both as conducted directly by the therapists in the TOS Center and in helping other therapists closer to the patient’s home to provide optimal treatment
  • Expertise and complete commitment to comprehensive surgical management for ALL forms of TOS, including:
    • Open surgical techniques
    • Applicable endovascular approaches
    • Close supervision of post-operative care and pharmacological management, and long-term clinical follow-up

Although even experienced surgeons may otherwise perform only one to two operations for TOS a year, our concentration on this problem supports more than 150 operations per year, one of the largest ongoing surgical experiences in the United States.

During the course of evaluating many patients with upper extremity neurovascular compression syndromes, we identify patients with TOS as well as those with findings more compatible with an alternative diagnosis.

A full spectrum of Washington University School of Medicine faculty experts in associated specialties — including neurology, neurosurgery, orthopedic surgery, thoracic surgery, and plastic and peripheral nerve surgery — are readily capable of diagnosis and treatment. When it is the preference of the referring physician and patient, the TOS Center can thereby serve as a portal for prompt referral and high-quality treatment for these associated conditions.

The patient volume and experience of the TOS Center translates into an unusual degree of familiarity with TOS and related disorders among our anesthesia colleagues, nursing staff, and other hospital personnel, as well as our own office staff and ancillary services.

All of these factors act in synergy to enhance the quality of the experience of patients who have been referred to the TOS Center for evaluation and treatment of TOS.