Thoracic Spine

Question 1

Thoracic outlet syndrome

Answer 1

=where blood vessels/ nerves between collarbone and first rib are compressed caused by physical trauma, repetitive injuries, anatomical defects
20-50 YOA
Risks- trauma from car injuries, repetitive injuries, anatomical defects, poor posture, tumours pressing on nerves, pregnancy, obesity
Symptoms- compression of brachial plexus (numbness, tingling, aches, pains, weakened grip), vein compression (discolouration, arm fatigue, throbbing lump near collarbone), artery compression (cold fingers, hands, arms, discolouration, weak pulse in hand)
Prognosis- symptoms will usually resolve on their own. Manipulative treatments, exercise and massage

Question 2

Intercostal neuralgia

Answer 2

=neuropathic pain in intercostal nerves
Caused by injury to intercostal nerves, inflammation to intercostal nerves
30-50YOA
Risks- cancer patients, pregnancy, surgical procedures
Symptoms- sharp, stabbing, pain in ribs, chest or abdomen, reduced motor function
Prognosis- variable. May turn chronic. NSAIDs, steroid injections, physical therapy to improve muscle strength

Question 3

Tietze syndrome

Answer 3

=swelling of cartilage of one or more upper ribs caused by multiple micro traumas to anterior chest wall
Before age 40
Risks- chronic coughing, vomiting or trauma to chest, viral/ bacterial infections, surgery to thoracic area
Symptoms- mild- severe localised pain/ tenderness in one or more upper 4 ribs, swelling in cartilage or rib, aching/ sharp neuralgic pain, redness/ warm
Prognosis- will often go away on its own but treatments can help ease pain/ swelling

Question 4

Precordial catch syndrome

Answer 4

=chest pain in front of heart
Caused by nerves getting pinched or irritated in the inner lining of the chest wall
Common In Children
Risks- age and when at rest
Symptoms- stabbing in chest, localised go one intercostal space, 30 second- 3 minute episodes
Prognosis- usually gets outgrown by 20. No treatment. Just deep breaths

Question 5

Herpes zoster (shingles)

Answer 5

=occurs years after chicken pox stays in the body
Caused by varicella- zoster virus
Any age but higher chance above 60
Risks- old age, weak immune system, cancer sufferers, transplant recipients
Symptoms- painful rash, sensitivity to touch, fluid filled blisters, itching, fever, headache
Prognosis- young, healthy patients will recover rapidly. Antiviral medications