Intercostal neuralgia

Introduction Intercostal neuralgia is a pain syndrome in the intercostal nerve innervation. Primary is rare, mostly secondary lesions. These include chest diseases such as pleurisy, pneumonia and aortic aneurysms. Thoracic vertebrae and rib trauma secondary to osteophyte formation or periostitis, thoracic and rib tumor or deformity, thoracic spinal tumor or inflammation. Herpes zoster intercostal neuralgia usually shows herpes between the corresponding ribs. The pain can occur before the herpes and can still exist for a long time after the regression. Intercostal neuralgia is mainly caused by frequent pain in one or several intercostals. It is sometimes exacerbated by episodes, sometimes stimulated by respiratory movements, and exacerbated by coughing and sneezing. When the pain is severe, it can be radiated to the shoulder or back of the same side, sometimes in a band shape.

Cause

The symptoms of intercostal neuralgia are both primary and secondary. Clinically, intercostal neuralgia is commonly seen, and primary intercostal neuralgia is rare. Secondary intercostal neuralgia is caused by lesions in adjacent organs and tissues, such as lesions of the thoracic organs (pleural inflammation, chronic lung inflammation, aortic aneurysm, etc.), spinal and rib injuries, senile spondyloarthritis, thoracic vertebrae Segmental spine deformity, thoracic spinal cord tumor, especially extramedullary tumor, often compresses nerve roots and has intercostal neuralgia symptoms. There is also an intercostal neuritis caused by herpes zoster virus, and intercostal neuralgia can also occur.

an examination

Related inspection

Blood routine CT examination chest B-ultrasound

In the onset of intercostal neuralgia, it can be seen that the pain is delayed from the posterior to the posterior and along the corresponding intercostal space. The pain is stinging or burning pain. Pain worsens when coughing, taking a deep breath, or sneezing. The pain is more common in one nerve on one side. Physical examination revealed significant tenderness in the thoracic spine and intercostal space. In patients with typical intercostal neuralgia, the neck test is positive. The distribution of affected nerves often has neurological impairment such as hyperesthesia or hypoesthesia.

Differential diagnosis

1. Primary intercostal neuralgia is rare, try to find out the diseases associated with this disease.

2. The range of pain is limited to the intercostal nerve distribution area of the lesion, which is more common in the 5 to 9 intercostal space on one side. The affected part showed severe pain in the arc and had a fixed pain point, which was aggravated by paroxysmal.

3. There are tender points along the intercostal nerve distribution area and its equivalent skin parts. The most common tender points are beside the spine, the sacral line and the sternum.

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