Superficial fasciitis

Introduction Myofasciitis, also known as fibroinitis, can only be regarded as a comprehensive concept, which has rarely been adopted in recent years. Fibrositis is a condition in which some patients with low back pain have small nodules on the surface of the iliac spine or at the attachment of the diaphragm, accompanied by pain and tenderness, and sometimes found on the buttocks. Muscular fasciitis is often manifested as pain at the site of the disease, mostly soreness and discomfort, muscle stiffness and stagnation, or a feeling of heavy pressure, sometimes with subcutaneous and degenerative myofascial and fibrous nodules. Symptoms worsen in the morning or in the weather and after the cold, and the pain is relieved after the activity, often repeated. In acute exacerbations, local muscle tension, paralysis, and limited activity.

Cause

Fasciitis refers to the aseptic inflammation of muscles and fascia. When the body is stimulated by external factors such as cold, fatigue, trauma or improper sleeping position, it can induce acute exacerbation of muscle fasciitis, shoulder and neck and waist. Acute or chronic injury or strain of muscles, ligaments, and joint capsules is the basic cause of the disease. Chronic muscle pain, soreness and weakness can be repeated due to repeated stress or cold and other unpleasant stimuli due to repeated treatment in the acute phase. The etiology is due to the inability of the muscles to inactivate the capillaries and poor microcirculation.

an examination

Related inspection

Blood routine white blood cell count (WBC)

Muscular fasciitis is often manifested as pain at the site of the disease, mostly soreness and discomfort, muscle stiffness and stagnation, or a feeling of heavy pressure, sometimes with subcutaneous and degenerative myofascial and fibrous nodules. Symptoms worsen in the morning or in the weather and after the cold, and the pain is relieved after the activity, often repeated. In acute exacerbations, local muscle tension, paralysis, and limited activity.

Neck and shoulder muscle fasciitis

Wide neck and shoulder pain, soreness, heavy feeling, numbness, stiffness, limited mobility, can be released to the back and upper arms. The pain is persistent and can be aggravated by factors such as infection, fatigue, cold, and dampness. Physical examination of the neck muscle tension, tender points often in the spinous process and paraspinal paraspicious muscles, rhomboid muscles, etc., tenderness limitations, do not run along the nerves. The disease is slow and has a long course. X-rays are mostly negative results.

Eosinophilic fasciitis: It is a disease characterized by diffuse swelling and hardening of the fascia. Therefore, it is advocated to use "sclerosing fasciitis". The disease is rare in the clinic.

Nodular fasciitis: also known as pseudosarcoma fasciitis, is a reactive, self-limiting superficial fascia nodular fibroblastic proliferative lesion, the cause of which is unknown, may be related to trauma or infection.

Lumbar back muscle fasciitis: refers to a series of clinical symptoms caused by edema, exudation and fibrosis of the fascia and muscle tissue of the lower back due to cold, damp and chronic strain. It is a non-specific change in the body's white fibrous tissue, such as fascia, sarcolemma, ligament, tendon, tendon sheath, periosteum and subcutaneous tissue. It is a pain that is common in the clinic and often overlooked or misdiagnosed.

Plantar fasciitis: The muscles in the soles of the feet are subjected to external force violence or long-term walking causes local muscle strain to cause local fascia inflammation, which is characterized by local pain and the heaviest walking. The most common symptom of plantar fasciitis is the pain and discomfort of the heel, and it is also the most common cause of heel pain. In general, the first step in pain when getting out of bed in the morning is most obvious. This is mainly because after a night's rest, the plantar fascia is no longer loaded and will be in a shorter state. Therefore, when the bed is stepped on the ground in the morning, a large and faster pulling of the plantar fascia is caused, which causes pain. However, after walking for a while, the plantar fascia will become looser and the symptoms will be relieved. However, if you walk too much, the number of times the plantar fascia is pulled is increasing, and the symptoms will reappear.

Differential diagnosis

The superficial fascia of the thoracic and lateral regions continues with the superficial fascia of the neck, abdomen and upper limbs, and contains fat, superficial blood vessels, lymphatic vessels, cutaneous nerves and breast. The individual thickness varies greatly, the front of the sternum is thinner, and the rest is thicker and needs to be identified.

1. The cutaneous nerves in the anterior and lateral regions of the cutaneous nerve are from the cervical plexus and the upper branch of the ligament nerve. 3 to 4 of the supraclavicular nerves, which are emitted from the cervical plexus and extend across the front of the clavicle through the neck, and are distributed in the upper part of the chest area and the skin of the shoulder. Anterior and lateral cutaneous branches of the intercostal nerve: except for the distribution of the supraclavicular nerves in the chest and lateral regions, the rest are distributed by the anterior and lateral branches of the intercostal nerve. The intercostal nerves are laterally distributed near the anterior iliac crest, distributed in the lateral thoracic region and the lateral part of the thoracic region. The anterior cutaneous branch is distributed on both sides of the sternum and distributed in the medial part of the chest area. The distribution of the cutaneous branch of the intercostal nerve is obviously segmental, and it is arranged in a circular strip shape from top to bottom according to the nerve sequence. The second rib nerve is distributed in the sciatic plane skin, the lateral cutaneous branch is still distributed to the medial part of the arm; the fourth intercostal nerve to the nipple plane; the sixth intercostal nerve to the sword chest combined plane; the eighth intercostal nerve to the rib Bow plane. The anesthesia plane and the diagnosis of spinal cord injury segments can be determined based on the distribution of the cutaneous nerve. The distribution of adjacent cutaneous nerves overlap each other to jointly manage the skin sensation of a band. For example, the skin of the fourth intercostal plane receives the cutaneous branch from the third and fifth intercostal nerves in addition to the fourth intercostal nerve branch. Therefore, an intercostal nerve is damaged, and the sensory disturbance in the distribution area is not obvious. When the adjacent two rib gate nerves are damaged, the loss of the feeling of the joint management zone is observed.

2. The superficial blood vessels are mainly supplied by the branches of the internal thoracic artery, the posterior ribs, and the iliac artery. The vein is merged into the chest and abdominal wall vein and the accompanying vein of the above artery. Perforator of the internal thoracic artery: small, about 1 cm away from the lateral edge of the sternum, distributed to the medial part of the chest area. Women's 2nd to 4th wearers are larger, branching to the breast, and attention should be paid to ligation of these blood vessels when performing radical mastectomy. The anterior and lateral cutaneous branches of the posterior intercostal artery are accompanied by the same-named branches of the intercostal nerve, which are distributed to the chest, lateral area muscles, skin and breasts, respectively. The branches of the above two arteries are accompanied by veins, which are respectively introduced into the internal thoracic vein and the posterior intercostal vein.

Thoracic wall vein: from the umbilical vein network, slanting outward along the lateral part of the thoracic region, into the lateral thoracic vein, collecting venous blood in the upper part of the abdominal wall and the shallow part of the thoracic lateral area. This vein is one of the important channels for communicating the superior and inferior vena cava. When the blood flow of the portal vein is blocked, the collateral circulation of the portal vein is established by this vein, and the blood flow is increased and varicose.

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