Thoracic Spine Overview

Question 1

1 year prevalence of thoracic pain in adults

Answer 1

15%

1 month <1%

Question 2

reacurence over 1-4 year period in children

Answer 2

13-45% of ppl

Question 3

How large is the disk in the thoracic spine in relation to other areas of the spine

Answer 3

thinnest

Question 4

Rib fx- Moi, signs, exam, mngmt

Answer 4

moi- not associated w distinct trauma

signs- acute pain w all motions

Exam- gentel rib springing

Mnmt- imaging

Question 5

VB fx- MOI, signs, management

Answer 5

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

Question 6

diagnostic criteria for Fibromyalgia

Answer 6

-widespread pain index >7
-symtom severity >5
pain in 4 or 5 regions (r/l upper, lower, axial)
-pain for 3+m

Question 7

What is Ankylosing Spondylitis

Answer 7

Chronic systemic, imflamatory arthritis causing back pain

Question 8

Prevelence, gender and onset of Ank Spondylitis

Answer 8

.1-2%
2;1-5:1 males;females
onset- 15-35yo

Question 9

when would people with ank spindylytis be most stiff

Answer 9

30+ mins of morning stiffness (excercise would give relief)

Question 10

Axial spndyloarthritis clinical features

Answer 10

• imflammatory back pain
• heel pain
• pos fam history
• finger inflamation
• imflamatory bowel disease
• alternating butt pain

Question 11

Axial spondyloarthritis conservative tx

Answer 11

Goals of maintaing mob, flexability, function etc

Smt contra in flare ups
exercise
med management

Question 12

How would intercostal nerve lesion present

Answer 12

due to overlap of adjacent nerves , sensory loss is rare in single intercostal nerve lesion (generally 2+ adjacent intercostals are involved)

Question 13

Signs and symptoms of herpes zoster

Answer 13

=papulovesicular rash along nerve root distribution

• doesnt cross midline
• contageous

Question 14

what is post herpetic neuralgia and how does it present

Answer 14

after herpes zoster in 20-25% of pts.

may involve c3-5 or shoulder, hemidiaphragmtic pain

Question 15

TDisk herns represent how many spinal disc lesions

Answer 15

<1%

Question 16

critical zone for thoracic disk disease

Answer 16

T4-9

Question 17

Peak incidence age of TDH and loc

Answer 17

40s most central or centralat

Question 18

mc area of TDH

Answer 18

75% occur bellow T8 with peak at t11-12

Question 19

what is the mc cause of thoracic radiculopathy

Answer 19

diabetes mellitus

Question 20

Thoracic disk disease signs/symptoms

Answer 20

band like chest pain
lower limb pain
abdominal wall bulging
vague visceral pain 
tenderness

Question 21

What is rib dysfunction

Answer 21

Includes costovertebral jts and costotransverse jt + surrounding tissue
(may mimic cardiac disorders)

Question 22

Rib dysfuction presentation

Answer 22

sharp pain
agrevated by motion
upper ribs agrrevated by reaching
lower ribs aggrevated by bending tweisting
-increased pain w sneezing/coughing

Question 23

Rib dysfunction tx

Answer 23

SMT (should be instant relief

-heat, ice, mobs etc

Question 24

ddxs of rib dysfunction

Answer 24

myofascial strain
thoracic facet syndrome
thoracic disk disease

Question 25

Thoracic facet syndrome pain pattern/findings

Answer 25

pain normally ipsilateral to affected jt, decreased ROM/jt play and pain

Question 26

presentation of costochondritis

Answer 26

pain + tenderness of the costochondral junctions
m/c at 2-5 costocartilages
usually trauma

Question 27

Sternoclavicular jt syndrome MOI, pop, symptoms

Answer 27

trauma usually in contact sports

point tenderness, swelling, crepitus