gilbert thomson
20-05-2008, 09:22 AM
Diane
Had a gentleman today with intermittent thoracic pain spreading around chest bilaterally, L > R, with L arm pain a week ago. He had been hospitalised (understandably) as everyone thought it was cardiac in origin. Happily all tested negative for that so he was referred to me diagnosed with MS chest pain.
He has a point just 1 cm lateral to T5 that is very tender when palpated and the pain spreads right around his chest. (Also has a tender spot on the other side near the same level.)
He responded nicely to my approximation of DNM (I only may have had my thumb too firmly over the tender spot). After approx 3 minutes it was no longer tender at all.
What nerve(s) would you suspect are mainly involved? T5 nerve root or just the dorsal ramus which innervates the skin in that area?
cheers
-Gilbert
Had a gentleman today with intermittent thoracic pain spreading around chest bilaterally, L > R, with L arm pain a week ago. He had been hospitalised (understandably) as everyone thought it was cardiac in origin. Happily all tested negative for that so he was referred to me diagnosed with MS chest pain.
He has a point just 1 cm lateral to T5 that is very tender when palpated and the pain spreads right around his chest. (Also has a tender spot on the other side near the same level.)
He responded nicely to my approximation of DNM (I only may have had my thumb too firmly over the tender spot). After approx 3 minutes it was no longer tender at all.
What nerve(s) would you suspect are mainly involved? T5 nerve root or just the dorsal ramus which innervates the skin in that area?
cheers
-Gilbert