A 32-year-old patient with neck stiffness and arm pain who reports cold fingers that worsen with keyboard use would most likely be examined with which maneuver?

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The situation points to thoracic outlet syndrome, where neurovascular structures passing from the neck to the arm are squeezed, leading to arm pain, numbness, and even cold fingers with certain postures or activities. The Roos maneuver places the arms in a position that maximally narrows the thoracic outlet—about 90 degrees of abduction with the elbows flexed, and the patient repeatedly opens and closes the hands. If this reproduces or worsens symptoms such as arm pain, weakness, numbness, or a sensation of cold in the fingers, it strongly suggests vascular or neurogenic compression at the outlet. The other tests target different problems: Phalen and Tinel evaluate carpal tunnel syndrome at the wrist, while Soto-Hall is used to screen for cervical spine or meningeal-related issues. In this scenario, the maneuver most likely to elicit the symptom constellation is the Roos test.