Thoracic Spine Overview Flashcards
1 year prevalence of thoracic pain in adults
15%
1 month <1%
reacurence over 1-4 year period in children
13-45% of ppl
How large is the disk in the thoracic spine in relation to other areas of the spine
thinnest
Rib fx- Moi, signs, exam, mngmt
moi- not associated w distinct trauma
signs- acute pain w all motions
Exam- gentel rib springing
Mnmt- imaging
VB fx- MOI, signs, management
MOI- younger- fall on butt/ hyper flex, older-osteoperosis
Signs- sudden onset, acute pain, after mild trauma
managemnet- metastatic suspition= med referal, stable= managemnet , avoid flex
diagnostic criteria for Fibromyalgia
-widespread pain index >7
-symtom severity >5
pain in 4 or 5 regions (r/l upper, lower, axial)
-pain for 3+m
What is Ankylosing Spondylitis
Chronic systemic, imflamatory arthritis causing back pain
Prevelence, gender and onset of Ank Spondylitis
.1-2%
2;1-5:1 males;females
onset- 15-35yo
when would people with ank spindylytis be most stiff
30+ mins of morning stiffness (excercise would give relief)
Axial spndyloarthritis clinical features
- imflammatory back pain
- heel pain
- pos fam history
- finger inflamation
- imflamatory bowel disease
- alternating butt pain
Axial spondyloarthritis conservative tx
Goals of maintaing mob, flexability, function etc
Smt contra in flare ups
exercise
med management
How would intercostal nerve lesion present
due to overlap of adjacent nerves , sensory loss is rare in single intercostal nerve lesion (generally 2+ adjacent intercostals are involved)
Signs and symptoms of herpes zoster
=papulovesicular rash along nerve root distribution
- doesnt cross midline
- contageous
what is post herpetic neuralgia and how does it present
after herpes zoster in 20-25% of pts.
may involve c3-5 or shoulder, hemidiaphragmtic pain
TDisk herns represent how many spinal disc lesions
<1%
critical zone for thoracic disk disease
T4-9
Peak incidence age of TDH and loc
40s most central or centralat
mc area of TDH
75% occur bellow T8 with peak at t11-12
what is the mc cause of thoracic radiculopathy
diabetes mellitus
Thoracic disk disease signs/symptoms
band like chest pain lower limb pain abdominal wall bulging vague visceral pain tenderness
What is rib dysfunction
Includes costovertebral jts and costotransverse jt + surrounding tissue
(may mimic cardiac disorders)
Rib dysfuction presentation
sharp pain agrevated by motion upper ribs agrrevated by reaching lower ribs aggrevated by bending tweisting -increased pain w sneezing/coughing
Rib dysfunction tx
SMT (should be instant relief
-heat, ice, mobs etc
ddxs of rib dysfunction
myofascial strain
thoracic facet syndrome
thoracic disk disease
Thoracic facet syndrome pain pattern/findings
pain normally ipsilateral to affected jt, decreased ROM/jt play and pain
presentation of costochondritis
pain + tenderness of the costochondral junctions
m/c at 2-5 costocartilages
usually trauma
Sternoclavicular jt syndrome MOI, pop, symptoms
trauma usually in contact sports
point tenderness, swelling, crepitus
