Neurogenic Thoracic Outlet Syndrome (NTOS), which is estimated to account for more than 90% of all TOS presentations, remains elusive in both physical examination and diagnosis. Patients often complain of symptoms that are unrecognizable on X-Ray, MRI, and nerve conduction studies. This can be perplexing for patients seeking an origin to the pain and paresthesia they are experiencing in their upper extremity. Physical exam tests, although still useful clinically, lack the sen