1/4. Musculoskeletal causes of chest pain.BACKGROUND: chest pain is a common presenting problem to general practitioners and accident and emergency departments. Such a symptom generates anxiety in both patients and their medical attendants, for fear that this symptom represents a life threatening event. Numerous investigations often ensue, adding to the physical and financial burden on an already stressed health system. Musculoskeletal causes of chest pain are common but frequently overlooked. OBJECTIVE: This article aims to outline some of the more common musculoskeletal problems which may present as chest pain, and to present a practical approach to their diagnosis and management. DISCUSSION: It is estimated that somewhere in the vicinity of 20-25% of noncardiac chest pain has a musculoskeletal basis. Careful history taking to identify red flag conditions differentiates those who require further investigation. Historical features suggesting a musculoskeletal cause include pain on specific postures or physical activities. A musculoskeletal diagnosis can usually be confirmed by clinical examination alone, the key to which is reproducing the patient's pain by either a movement or more specifically palpation over the structure that is the source of the pain. Confirming the diagnosis, explanation and reassurance allay anxiety. Management strategies include manual therapy, the provision of analgesia and anti-inflammatory agents, either topically, orally or by injection. Focal injection of local anaesthetic alone may also be a useful diagnostic and therapeutic tool.- - - - - - - - - - ranking = 1keywords = chest pain, chest (Clic here for more details about this article) |
2/4. Xiphodynia: a report of three cases.Xiphodynia is an uncommon musculoskeletal disorder that mimics a number of common abdominal and thoracic diseases. We report three cases of xiphodynia. The diagnosis is suggested when a given patient's chest or abdominal discomfort is completely or almost completely reproduced with light pressure on the xiphoid process. Local injection with an anesthetic-steroid combination is frequently curative. No more than 5 to 7 mL of solution should be injected, and results are variable when several trigger points are found on the anterior chest wall. Tack hammer deformity of the xiphoid, another cause of xiphoid pain, has been successfully treated with surgical excision.- - - - - - - - - - ranking = 0.0083661414017291keywords = chest (Clic here for more details about this article) |
3/4. Fatal leptospirosis presenting as musculoskeletal chest pain.After holidaying in vanuatu, a 24-year-old man presented with pleuritic chest pain and chest wall tenderness thought to be musculoskeletal in origin. He developed fatal acute renal failure, jaundice, respiratory failure, myocarditis and rhabdomyolysis. Subsequent serological results showed a rise in serum titre of antibodies to leptospira grippotyphosa, from 1 : 50 to 1 : 800, consistent with acute infection.- - - - - - - - - - ranking = 0.71846878498658keywords = chest pain, chest (Clic here for more details about this article) |
4/4. chest pain and the role of somatic dysfunction.The symptom of chest pain may be a result or manifestation of somatic dysfunction of the musculoskeletal system. chest pain is a common chief complaint among patients in a family practice office or in the emergency room. Various intrathoracic and extrathoracic factors may be responsible. The authors describe their experience with one patient in whom osteopathic manipulative treatment was used along with accepted medical tests and therapy to diagnose and treat this patient. If chest pain is effectively diagnosed and promptly treated, OMT can provide the most thorough, cost-effective, and satisfying care available.- - - - - - - - - - ranking = 0.28571428571429keywords = chest pain, chest (Clic here for more details about this article) |