Thoracic spine pain

Introduction Thoracic vertebrae pain is the main clinical manifestation of the symptoms of thoracic spondylosis, including thoracic vertebrae hyperplasia, spinal canal stenosis; thoracic compression fracture, dislocation, scoliosis, fascia incarceration; and thoracic disc herniation.

Cause

Causes of thoracic pain

Thoracic spondylosis is mainly caused by degenerative hyperplasia of the thoracic vertebrae. The following thoracic vertebrae are more common. Thoracic hyperplasia causes thoracic stenosis, which causes the spinal cord to be compressed. There are rib joints between the two vertebral bodies. If the intervertebral space is narrowed, the edge of the vertebral body is proliferated, which can force the rib joint to dislocate and affect the respiratory movement. After the intercostal nerve is intervertebral foramen, it runs on the lower edge of the rib and can cause intercostal neuralgia when pulled or compressed.

an examination

Related inspection

Thoracic chest CT examination

Thoracic pain examination

Pain position: The position of the thoracic vertebrae from the level of the navel is about 15 cm vertically. There is a slight pain between the thoracic vertebrae and the thoracic vertebrae. It is the skin part of the back and the skin is slightly to the right. Chronic and slightly painful, the pain is slightly heavy by hand.

Lateral thoracic vertebrae: visible lip-like hyperplasia of the anterior border of the vertebral body. Most of them show a widening of the thoracic intervertebral space narrowing, cartilage plate sclerosis, anterior or lateral margin of the vertebral body. In some cases, the shadows of the Smolen nodules, the curvature of the thoracic spine, and the deepening of the physiological curvature were observed.

Differential diagnosis

Differential diagnosis of thoracic pain:

1, chest pain: chest pain is a common symptom in the emergency department, usually caused by chest disease, the severity of chest pain does not necessarily have a definite relationship with the cause of chest pain, such as chest herpes zoster can produce severe chest pain, and acute myocardial infarction Chest pain is sometimes not very serious.

2, chest wall pain: chest wall pain (chestwallpain) also known as musculoskeletalpain (musculoskeletalpain).

The place of pain is only concentrated, and the patient can clearly point it out.

The pain is not long, and usually only lasts for one or two seconds, and there is a chance to relapse.

When the patient takes a deep breath, coughs, sneezes or turns around, the chest is stinging and even painful.

Pain may be more intense than chest pain caused by other diseases, but most of them improve within a few days to two or three weeks.

It will be affected at any age.

3, side rib pain: experts do not know what causes rib pain, it is generally considered to be related to daily life, such as exercise beyond the ability, improper sucking, dehydration or exercise immediately after meals.

4, the intercostal space may have tenderness: the intercostal space may have tenderness is the clinical manifestation of intercostal neuralgia. Physical examination of patients with intercostal neuralgia found that there was significant tenderness in the paraspinal and intercostal space of the thoracic spine; typical patients with intercostal intercostal neuralgia had a positive neck test; the distribution of affected nerves often showed neurological impairment such as hyperesthesia or hypoesthesia. .

5, dry hypochondriac pain: Chinese medicine said that the dry hypochondriac pain is due to pulmonary sputum and other lesions invading the pleura, burning sputum, qi and blood stasis, collaterals. It is a painful disease mainly characterized by chest pain, dry cough, and pleural friction sound.

6, the second costal cartilage pain: costal cartilage inflammation is slow. Its prominent clinical manifestations are affected gastric cartilage bulging, swelling, obvious spontaneous pain and tenderness, local redness and heat changes. In most cases, only a single costal cartilage is invaded, and there are also more than 2 cases or multiple bilateral costal cartilage in individual cases. The most common lesion-prone site is the left second costal cartilage, followed by the right second costal cartilage and the third, fourth, first costal cartilage.

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