What causes breast pain? Discover the common reasons for breast pain, including hormonal changes, dietary factors, breast cysts, and costochondritis. Get expert insights on managing breast pain effectively.

Understanding Breast Pain

Breast pain, also known as mastalgia, is a common condition that affects many women. Contrary to its significance in most parts of the body, breast pain is usually not a sign of a serious problem. In fact, it most often represents sensitivity of normal breast tissue to dietary factors, medications, or hormonal changes.

Causes of Breast Pain

Hormonal Changes and the Menstrual Cycle

Most women are familiar with the cyclic pattern of breast pain and sensitivity related to the hormonal changes of the menstrual cycle. Symptoms often affect both breasts, but can affect one breast more than the other and generally increase in severity prior to a period. The pain typically involves the whole breast or a consistent area, such as the upper, outer breast or the central breast including the nipple.

Dietary Triggers and Medications

Non-cyclic breast pain may be due to dietary triggers, including caffeine, which is found in a variety of beverages and foods. Similar variable breast sensitivity has been associated with hormonal medications, some dietary supplements, and other foods like large amounts of dietary soy. Sometimes, it’s not possible to identify a specific cause, but the breasts are sensitive to an external factor, producing the discomfort.

Breast Cysts

Some breast pain arises from the breast tissue itself and is often more localized than the type caused by sensitivity. An example would be pain from an inflamed or enlarging breast cyst. Cysts are fluid-filled spaces in the gland tissue of the breast and are almost always associated with some hormonal activity.

Costochondritis

Perhaps the most common cause of localized “breast pain” is costochondritis – inflammation in the ribs behind the breast. This may be due to increased physical activity or trauma, but often there is no known cause. The pain may be constant and achy or intermittent and sharp, but is always associated with tenderness over specific trigger points on the affected ribs, usually near the center of the chest.

Diagnosing and Treating Breast Pain

Only rarely is breast pain the first symptom of a breast cancer. However, a careful medical history, clinical breast exam, and updated breast imaging with mammography and ultrasound are always appropriate, particularly if there is no obvious explanation for the pain.

If it’s possible to identify and modify the trigger, the symptoms will be improved. In addition, a well-fitting supportive bra, application of cool or warm compresses, and use of ibuprofen or a similar mild analgesic with an anti-inflammatory effect can be helpful in managing symptoms.

When to Seek Medical Attention

Consultation with a breast specialist is indicated anytime there is an ongoing or specific breast concern. Most women will find a comfortable way to manage their symptoms, even if they do not completely resolve.

Key Takeaways

• Breast pain is usually not a sign of a serious problem, but rather a challenge of symptom management.
• Common causes include hormonal changes, dietary triggers, breast cysts, and costochondritis.
• Identifying and modifying the trigger, along with using supportive bras, compresses, and anti-inflammatory medications, can help manage breast pain.
• Consultation with a breast specialist is recommended for ongoing or specific breast concerns.

Frequently Asked Questions

Is breast pain a sign of breast cancer?

No, breast pain is usually not a sign of breast cancer. Breast cancer almost always causes other symptoms, such as a prominent breast lump or a visible change in the breast appearance, before causing pain.

Can diet and medications cause breast pain?

Yes, dietary triggers like caffeine and certain medications, including hormonal medications, can cause variable breast sensitivity and pain in some women.

What is costochondritis and how does it cause breast pain?

Costochondritis is inflammation in the ribs behind the breast, which can cause localized and often sharp pain that feels like it’s coming from the breast itself. This is one of the most common causes of “breast pain”.

How can breast pain be managed?

Managing breast pain often involves identifying and modifying any triggers, wearing a supportive bra, using cool or warm compresses, and taking anti-inflammatory medications like ibuprofen.

What Causes Breast Pain? | Fox Chase Cancer Center

Updated: February 26, 2020

Pain is one of the most common breast symptoms prompting women to seek medical attention. However, contrary to its significance in most parts of the body, pain in the breasts is usually not a sign of a serious problem.

It most often represents sensitivity of normal breast tissue to dietary factors, medications, or hormonal changes. Mastalgia, or breast pain, can also arise from breast cysts, localized infections, or inflammation in the muscles or ribs behind the breasts, most of which can easily be identified and treated.

In the rare situation where pain is the result of breast cancer, it almost always occurs after the cancer has become obvious in other ways – such as a prominent breast lump or a visible change in the breast appearance. In summary, breast pain typically represents a challenge of symptom management, not a threat to life.

Most women are familiar with the cyclic pattern of breast pain and sensitivity related to the hormonal changes of the menstrual cycle. Symptoms often affect both breasts, but can affect one breast more than the other and generally increase in severity prior to a period. Usually the pain involves the whole breast, or one consistent area of the breast – often the upper, outer breast towards the armpit, or the central breast including the nipple. The pattern is familiar from month to month, and tends to resolve completely with the onset of menses.

Breast Pain Cause by Caffeine

Non-cyclic breast pain may be due to dietary triggers including caffeine, which is found in a variety of beverages and foods (coffee, tea, cola, chocolate) and may produce severe breast pain in some women with others experiencing no effect at all. Similar variable breast sensitivity has been associated with hormonal medications, some dietary supplements, and other foods including large amounts of dietary soy. Sometimes it is just not possible to isolate a specific cause, but in each of these situations the breasts are not the source of the problem; there is an external factor to which the breasts are sensitive, producing the discomfort.

If it is possible to identify and modify the trigger, the symptoms will be improved. In addition, a well-fitting supportive bra (ideally a sports bra), application of cool or warm compresses for comfort, and use of ibuprofen (or a similar mild analgesic with an anti-inflammatory effect) can be helpful in managing symptoms. It is important to understand that, because this type of breast pain relates to breast tissue sensitivity, it may be uncomfortable but is not harmful.

Breast Pain Caused by Cysts

Some breast pain does arise from the breast tissue itself and is often more localized than the type caused by sensitivity. An example would be pain from an inflamed or enlarging breast cyst. Cysts are fluid-filled spaces in the gland tissue of the breast and have no known cause, although they are almost always associated with some hormonal activity (women who are premenopausal or taking some type of estrogen/progesterone medication). Most cysts do not cause symptoms but, if the fluid is under pressure or if inflammation is present, the cyst may become tender and produce a lump. Ibuprofen and cool compresses will help, but aspiration of the fluid may be necessary to relieve the pressure and the pain. These cysts rarely recur after aspiration, but some women are prone to multiple cysts over time.

Costochondritis: The Most Common Cause of Breast Pain

Perhaps the most common cause of localized “breast pain” is costochondritis – inflammation in the ribs behind the breast. This may be due to increased physical activity or trauma, but often there is no known cause. The pain may be constant and achy or intermittent and sharp, but is always associated with tenderness over specific trigger points on the affected ribs, usually near the center of the chest. Because the pain is originating directly behind the breast, it often feels as though it is coming from the breast itself. This condition may resolve without treatment, but is similar to mild arthritis and can be treated with a short course of anti-inflammatory medication such as ibuprofen or naproxen.

Only rarely is breast pain the first symptom of a breast cancer, but a careful medical history, clinical breast exam, and updated breast imaging with mammography and ultrasound, when necessary, are always appropriate, particularly if there is no obvious explanation for the pain. A trial of symptom treatment is often successful even in the absence of a definite diagnosis, and most women will find a comfortable way to manage their symptoms even if they do not completely resolve. However, consultation with a breast specialist is indicated anytime there is an ongoing or specific breast concern.

Learn more about treatment for benign breast disease and breast cancer at Fox Chase.

Chest wall pain | Breast Cancer Now

1. What is chest wall pain?
2. Symptoms 
3. Diagnosis
4. Treatment 
5. Coping with chest wall pain

1. What is chest wall pain?

Chest wall pain may feel as though it’s coming from the breast, but really it comes from somewhere else. It’s also known as extra-mammary (meaning outside the breast) pain.

Chest wall pain can have a number of causes, including:

• pulling a muscle in your chest 
• inflammation around the ribs, caused by conditions called costochondritis or Tietze’s syndrome 
• a medical condition such as angina or gallstones 

Breast pain can have a number of other causes, but on its own is not usually a sign of breast cancer.

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2. Symptoms of chest wall pain

The pain can be on one side, in a specific area or around a wide area of the breast. 

It may be burning or sharp, may spread down the arm and can be worse when you move.

This type of pain can also be felt if pressure is applied to the area on the chest wall.

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3. Diagnosing chest wall pain

See your GP if your breast pain is new and carries on. 

Your GP will examine your breasts and take a history of the type of pain you have and how often it occurs. To check how long the pain lasts for, how severe the pain is or if the pain may be linked to your menstrual cycle, your GP may ask you to fill in a simple pain chart. 

If your GP thinks you may have chest wall pain, they may ask you to lean forward during the examination. This is to help them assess if the pain is inside your breast or in the chest wall. 

Your GP may refer you to a breast clinic where you’ll be seen by specialist doctors or nurses for a more detailed assessment.

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4. Treating chest wall pain 

Treatment for chest wall pain will depend on what’s causing it. 

If it’s found that your breast pain is caused by a pulled muscle in your chest, this is likely to improve over time and can be treated with pain relief. 

Chest wall pain can also affect the area under the arm and towards the front of the chest, and this may be due to: 

• costochondritis – inflammation of parts of the ribs (called costal cartilages) 
• Tietze’s syndrome – inflammation of the costal cartilages and swelling

Your GP or specialist may be able to tell that the costal cartilages are painful if pressure is put on them. Sometimes this inflammation can feel similar to heart (cardiac) pain. You may feel tightness in the chest and a severe, sharp pain. The pain may also spread down the arm and can be worse when you move. 

You may find it helpful to rest and avoid sudden movements that increase the pain. Pain relief such as paracetamol or a non-steroidal anti-inflammatory such as ibuprofen (as a cream, gel or tablet) may help. 

Your specialist may suggest injecting the painful area with a local anaesthetic and steroid. 

Smoking can make the inflammation worse, so you may find that your pain lessens if you cut down or stop altogether.

The NHS website has more information about costochondritis and Tietze’s syndrome.

Pain caused by other medical conditions, such as angina (tightness across the chest) or gallstones, may be felt in the breast. Your GP or specialist will advise you on the most appropriate treatment.

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5. Coping with chest wall pain

Any type of breast pain can be very distressing, and many women worry they may have breast cancer. However, in most cases pain in the breast isn’t a sign of breast cancer.  

Having breast pain doesn’t increase your risk of breast cancer. However, it’s still important to be breast aware and go back to your GP if the pain increases or changes, or you notice any other changes in your breasts. 

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Costochondritis and Arthritis: Understanding Symptoms and Treatment

If you’re like me, you probably won’t have heard of costochondritis until you or someone you know is diagnosed with it. I speak from experience because costochondritis, an inflammation of the segments of cartilage — called costosternal joints — that connect the ribs to the breastbone, wasn’t even on my radar when I went to the emergency room late one recent night with pain and tightness in my chest.

Turns out I’m far from the first person with costochondritis to show up in the ER thinking they might be having a heart attack. According to one study, 30 percent of patients who went to the ER with chest pain had costochondritis.

Costochondritis and Arthritis: What’s the Link?

Costochondritis is not as common as inflammation in the joints of the hands, elbows, knees, or feet, but if you have inflammatory arthritis like rheumatoid arthritis, ankylosing spondylitis, or psoriatic arthritis, you may also be more likely to get costochondritis.

“When you have a condition that predisposes you to inflammation over multiple joints, you have increased susceptibility to developing it,” says Vinicius Domingues, MD, a rheumatologist in Daytona Beach, Florida, and medical advisor for CreakyJoints.

Though costochondritis can happen at any age, it is more common in people over 40 and, like inflammatory arthritis, it affects women more than men — 70 percent versus 30 percent.

Symptoms of Costochondritis

The most common symptom of costochondritis is pain and tenderness in the chest that’s typically described as sharp, aching, or pressure-like.

The ribs and breastbone connect in seven different places and pain can occur at any of them or even at more than one location.  Costochondritis often occurs on just one side and frequently on the left side, which is why it’s often mistaken as a symptom of a heart attack.

One tipoff that it’s not a cardiac event is that your chest is painful to the touch (something that doesn’t happen when you’re having a heart attack). My doctor diagnosed my costochondritis by pressing on my chest, which hurt like hell.

Other clues it’s costochondritis: Pain is often exacerbated by upper body movement and deep breathing, even if it’s just reaching up into a high cupboard or blow-drying your hair (yes, again, I speak from experience). Moving the arm on the affected side will usually also cause pain.

But remember: Any time you experience chest pain, you should seek medical attention. Don’t attempt to assess for yourself whether or not you may be having costochondritis, a heart attack, or something else.

Causes of Costochondritis

If you live with a form of inflammatory arthritis, that may be all it takes for the costochondral joint to become inflamed. Other reasons for costochondritis include:

• Strain from coughing
• Injury to your chest
• Infections, including respiratory tract infections or post-op infections
• Physical strain from repeated exercise or sudden exertion

According to my doctor it doesn’t take much to develop costochondritis from exertion. Because I developed costochondritis around the holidays, she asked if I’d recently lifted a turkey. I traced it to a vigorous workout on the elliptical machine followed the next day by some strenuous yardwork.

Treatment for Costochondritis

The pain from costochondritis often goes away on its own in a few days or weeks, but it can also take up to a few months or longer. It’s unusual for costochondritis to become chronic, says Dr. Domingues.

Treatment includes rest, ice or moist heat (if you can stand the cold, Dr. Domingues suggests alternating each for 20 minutes a few times a day), and nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen, naproxen, and aspirin. Here are answers to common patient questions about taking NSAIDs.

Of course, refrain from any physical activity that makes the pain worse. I found the pain from costochondritis to be exhausting so I laid quietly in bed on my stomach as much as possible (laying on my back seemed to exacerbate the pain). It took about a week for my pain to go away completely. If yours persists, physical therapy and/or steroid injections can help. The good news: By all accounts, these remedies are rarely necessary.

Track Your Arthritis Symptoms

Use our ArthritisPower app to track your symptoms and disease activity and share your results with your doctor. Learn more and sign up here.

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Costochondritis | healthdirect

On this page

What is costochondritis?

Costochondritis is an inflammation in the cartilage that joins your ribs to your breastbone. It is also called chest wall pain or costosternal syndrome. It can cause sharp chest pain and tenderness, similar to the feeling you may get from a heart, lung or tummy problem.

Although it usually gets better after a few weeks, it can sometimes last longer.

What are the symptoms of costochondritis?

Costochondritis causes a sharp, aching or pressure pain and tenderness in your chest. The pain often gets worse:

• if you cough, sneeze or breathe deeply
• if you move
• if you put pressure on your chest by using a tight seatbelt or hugging someone

The symptoms may develop gradually or start suddenly. The pain is usually on the left side of your breastbone and affects more than one rib.

It might feel like you’re having a heart attack. If you are in doubt, see your doctor as soon as possible. If you have chest pain and have trouble breathing, feel sick or are sweaty, dial triple zero (000) for an ambulance.

Costochondritis is sometimes confused with a rare condition called Tietze syndrome, which has similar symptoms but also causes chest swelling.

Read more about chest pain.

CHECK YOUR SYMPTOMS — Use healthdirect’s chest and back pain Symptom Checker and find out if you need to seek medical help.

What causes costochondritis?

There is usually no obvious cause. Sometimes it can be due to:

How is costochondritis diagnosed?

Your doctor can diagnose costochondritis by talking to you and examining you. You may also be asked to have blood tests, x-rays or an electrocardiogram to rule out other causes of your pain.

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How is costochondritis treated?

Costochondritis usually gets better by itself. While you have the condition, avoid activities that aggravate it, such as reaching up into a high cupboard or strenuous exercise.

You can ease the pain by:

• avoiding strenuous activity
• applying a heat pack
• gentle stretching
• taking non-prescription painkillers such as paracetamol or anti-inflammatory medicine such as ibuprofen

Your doctor may suggest corticosteroid injections into the joint or prescribe other medicines if your symptoms don’t ease.

Pain After Breast Cancer: Costocondritis

Pain after Breast Cancer: Costocondritis

Is pain after breast cancer normal?  The answer to this question is often vague. For many women, pain is a normal part of recovery after breast cancer treatment.  But for some women, persistent pain after breast cancer may be due to costocondritis.

Costrocondritis can be difficult to diagnose and, because of this, the process is frequently not straight forward.  One patient who developed costocondritis had the following experience: “I complained about discomfort and pain in my chest to my oncologist and he ordered an ultrasound.   It indicated the cartilage between my rib bones was lumpy and close to the skin. My doctor said this wasn’t anything to worry about because it had been there since I had the mastectomy operation. Then I asked my surgeon about it and he said it had probably been there forever but now my breast is gone I can feel it. But I did worry because it was below the area where my multi-focal tumors were situated.” So she continued to search for the reason for her pain and finally discovered the source: Costocondritis.

What is Costocondritis? 

Costocondritis is inflammation of the cartilage that joins the ribs to the breastbone (called costal cartilages). Also known as anterior chest wall pain, it causes discomfort in the chest wall around the breastbone or sternum and pain can range from mild to severe.

What does Costochondritis feel like? 

Costochondritis is a common problem in women who have been affected by breast cancer.  Costrochondritis pain acts up in a way similar to arthritis and, likewise, can range from mild to severe.   There may be tenderness over the anterior chest and pain may radiate to the back, shoulders, stomach or arms.  Flare ups can be triggered by over-working your arms, lifting, sweeping, or over extending and is aggravated by coughing, lifting, straining, sneezing and deep breathing.  Pain can be constant or intermittent and can last for several days, months or years.

Costochondritis or Tietze Syndrome- How do I know? 

Tietze Syndrome is a condition that causes localized musculoskeletal pain.  It occurs when costochondritis is accompanied by swelling in the areas surrounding the cartilage. The swollen and inflamed area around the cartilage may be tender to the touch and the skin overlying the cartilage may be reddened.

Physical Therapy for Costochondritis

Costochondritis symptoms oftentimes improve from treatments that are effective with arthritis pain. Treatment typically includes a combination of rest, physical therapy, analgesics to control pain, and anti-inflammatory medications such as Advil, Motrin, Aleve.  Physical therapy treatments may include ice, thoracic mobilization, techniques to facilitate breathing, and stretching exercises. In some cases of severe pain, cortisone injections or surgery have been utilized- with mixed results.

How to Get Treatment for Costochondritis

Therapy Achievements specializes in treating pain and mobility limits that are associated with cancer. Our therapists have advanced training in manual therapy techniques designed to reduce pain and swelling and enhance flexibility and movement. We have a satellite clinic located inside Clearview Cancer Institute to provide services to patients balancing chemo or radiation schedules. Call us to schedule(256) 509-4398

Costochondritis – StatPearls – NCBI Bookshelf

Continuing Education Activity

Costochondritis is a benign cause of chest wall pain that results from inflammation of the costal cartilage, the cartilage that connect the ribs to the sternum. Patients often present with chest pain; therefore, other causes of chest pain must be excluded with history and physical exam. If the patient’s history and physical exam warrant additional workup, this should be done before the diagnosis of costochondritis is made. This activity reviews the evaluation, diagnosis, and management of costochondritis and highlights the role of the interprofessional team in the care of affected patients.

Objectives:

• Describe the history and physical exam findings associated with costochondritis.

• Explain how to rule out more grave causes of chest pain prior to diagnosing a patient with costochondritis.

• Describe common treatments for costochondritis.

• Explain the importance of collaboration amongst interprofessional teams when evaluating patients for costochondritis.

Access free multiple choice questions on this topic.

Introduction

Costochondritis is a chest wall pain caused by inflammation of the costal cartilages or the area where the ribs meet the sternum, known as sternal articulations. It is a benign cause of chest pain. Patients often present with the chief complaint of chest pain; therefore, other causes of chest pain must be excluded with history, physical exam, and/or diagnostic testing prior to a diagnosis of costochondritis.

Etiology

Costochondritis is inflammatory. It is caused by inflammation of the costal cartilages and their sternal articulations, also known as the costochondral junctions.

Epidemiology

The epidemiology of costochondritis is not well established. In a small study published in 1994, there was a higher frequency of costochondritis seen in females and Hispanics. In a group of 122 patients presenting to the emergency department with chest pain not due to malignancy, fever, or trauma, costochondritis was the diagnosis in 36 of the patients (30%).[1]

History and Physical

As with any chest pain, history of present illness, past medical history, social history, family history, and a review of systems are very important. Many deadly causes of chest pain should be ruled out prior to establishing a diagnosis of costochondritis. Consider whether the chest pain history is a concerning indicator of acute coronary syndrome, pulmonary embolism, aortic dissection, pneumonia, esophageal injury, pneumothorax, among others. If there was recent trauma or fall, consider an occult rib fracture.

Typically, if chest wall pain is due to costochondritis, the patient will give a history of the pain worsening with movement and certain positions. The pain will also typically be worse when the patient takes a deep breath. The pain quality is variable, but it may be described as sharp or dull pain.

If the patient complains of radiating pain, shortness of breath, dizziness, exertional chest pain, fever, productive cough, nausea, etc., these are worrisome for other causes of chest pain. Consider pursuing other causes of chest pain prior to establishing a costochondritis diagnosis.

A good heart and lung exam are important to help build your differential diagnosis when a patient complains of chest pain or chest wall pain. If a patient’s chest wall pain is due to costochondritis, the pain is usually reproducible by mild-to-moderate palpation. Often, there is point tenderness where one or two ribs meet the sternum. One pitfall of the typical physical exam findings is that pain due to acute coronary syndrome can also be described as reproducible.[2]

Vital signs are also important. Patients with costochondritis should present with normal vital signs. If your patient is tachycardic or hypotensive, this should raise the suspicion of an alternative diagnosis as the cause of your patient’s chest pain.[3]

Evaluation

The purpose of the evaluation is to determine other causes of chest pain. There is not a test to diagnose costochondritis.

Laboratory

Consider a workup for acute coronary syndrome, pneumonia, pulmonary embolism, among others if the patient’s history and physical exam warrant this workup. 

No laboratory evaluation is necessarily required to diagnose costochondritis. It is important to use the laboratory evaluation to evaluate for other diagnoses that are in your differential.

Radiology

A chest x-ray should be considered in all patients with chest wall pain or chest pain to rule out pneumonia, spontaneous pneumothorax, lung mass, among others. 

A normal chest x-ray will be seen with costochondritis.

Other Tests

An electrocardiogram (ECG) should also be considered in all patients with chest wall pain or chest pain to rule out abnormalities associated with infectious causes of chest pain, ischemia, among others. 

A normal electrocardiogram will be seen with costochondritis.[3][4]

Treatment / Management

The treatment for costochondritis is a nonsteroidal anti-inflammatory drug (NSAID).

Some consideration can be given to a course of naproxen or meloxicam because these are dosed twice daily and once daily, respectively. Other NSAIDs can also be used, including ibuprofen. The NSAID of choice is based on provider/patient preference.

NSAIDs are contraindicated in acute and chronic kidney disease.

It is also important to discuss with patients the risk of gastritis with chronic NSAID use. 

If patients have severe or refractory costochondritis, refer for outpatient follow-up. Physical therapy is a treatment option for refractory costochondritis.[5][3]

Differential Diagnosis

The differential diagnosis for costochondritis is rather long. Some of the diagnoses included are associated with major morbidity and mortality.

Acute Coronary Syndrome (ACS)

This diagnosis should be considered in any patient presenting with chest pain. If you feel the patient’s history and physical are concerning for ACS, consider an ECG and troponin level to assist in ruling out ACS. The patient should also be on continuous cardiac monitoring while in the emergency department.

Pneumothorax

Consider the patient population at risk for spontaneous pneumothorax. A chest x-ray and/or point-of-care ultrasound (POCUS) can be used to assist in evaluating the possibility of pneumothorax.

Pneumonia

If the patient is complaining of a productive cough and/or fever or is high risk for pneumonia, consider this on your differential diagnosis. Pneumonia can cause chest pain in addition to the other symptoms we associate with the diagnosis. A chest x-ray, complete blood count (CBC), and a basic metabolic panel (BMP) can be helpful when considering this as a differential diagnosis. Vital signs are also important when considering this diagnosis.

Aortic Dissection

This is a medical and possibly a surgical emergency. Consider a CTA to evaluate for aortic dissection if this is a concern based on the patient’s history and physical exam.

Pulmonary Embolism

Ask about pulmonary embolism (PE) risk factors, such as malignancy, recent travel, recent surgery, personal history of PE or deep vein thrombosis (DVT) and symptoms, such as shortness of breath. Tachycardia can also be a sign of a PE. Consider using a clinical decision rule, such as PERC and Well’s criteria when considering PE. A D-dimer and/or CTA can be helpful when evaluating for a PE if this is on your differential diagnosis. There may also be nonspecific ECG and POCUS changes seen.

Esophageal Perforation

The healthcare professional must have a high clinical suspicion for this diagnosis, and it is often due to an iatrogenic cause, such as a recent endoscopy.  This patient’s pain should be severe and unrelenting, and typically, they present in shock with abnormal vital signs.[6]

Prognosis

Costochondritis is a self-limited condition.

Complications

This is a self-limited disease. Patients may present with refractory or recurrent costochondritis. The most important part of the diagnosis of costochondritis is ensuring other, more deadly causes of chest pain have been ruled out.

Deterrence and Patient Education

Educate the patient on proper dosing of NSAIDs and the importance of not taking over-the-counter NSAIDs in addition to the prescription provided.

Educate the patient on return precautions, including worsening chest pain, shortness of breath, dizziness, and syncope.

Pearls and Other Issues

Costochondritis should be a diagnosis of exclusion. Rule out other causes of chest pain that are associated with increased morbidity and mortality. Patients typically present with chest pain worse with breathing, and it is often positional. It should be reproducible on a physical exam, and the patient’s vital signs should be within normal limits. If ordered, labs, ECG, and chest x-ray should also be normal. Costochondritis is a self-limited disease. The standard of care is treatment with NSAIDs. Consider ECG and chest x-ray in all patients who present with a chief complaint of chest pain.[6]

Enhancing Healthcare Team Outcomes

Because costochondritis is a diagnosis of exclusion, it can be helpful to involve specialists when ruling out other causes of chest pain. While providers often complete the initial read of the chest x-ray and the ECG, radiology, and cardiology will complete the official reads. It is not uncommon for occult, non-displaced rib fractures to be missed on a chest x-ray following trauma, such as a fall or car accident. If there are any questionable ECG findings, it is prudent to discuss these with a cardiologist or electrophysiologist before diagnosing a patient with costochondritis.

If costochondritis becomes refractory, consider referral to orthopedics and/or physical therapy to assist with treating the patient in an attempt to improve the patient’s pain. Clinicians may also consider referrals to other specialists to evaluate for other causes of chest pain at this time, including gastroenterology and cardiology. There may be a second diagnosis complicating the initial diagnosis of costochondritis.[5][7]

References

1.

Disla E, Rhim HR, Reddy A, Karten I, Taranta A. Costochondritis. A prospective analysis in an emergency department setting. Arch Intern Med. 1994 Nov 14;154(21):2466-9. [PubMed: 7979843]

2.

Lanham DA, Taylor AN, Chessell SJ, Lanham JG. Non-cardiac chest pain: a clinical assessment tool. Br J Hosp Med (Lond). 2015 May;76(5):296-300. [PubMed: 25959942]

3.

Ayloo A, Cvengros T, Marella S. Evaluation and treatment of musculoskeletal chest pain. Prim Care. 2013 Dec;40(4):863-87, viii. [PubMed: 24209723]

4.

McConaghy JR, Oza RS. Outpatient diagnosis of acute chest pain in adults. Am Fam Physician. 2013 Feb 01;87(3):177-82. [PubMed: 23418761]

5.

Zaruba RA, Wilson E. IMPAIRMENT BASED EXAMINATION AND TREATMENT OF COSTOCHONDRITIS: A CASE SERIES. Int J Sports Phys Ther. 2017 Jun;12(3):458-467. [PMC free article: PMC5455195] [PubMed: 28593100]

6.

King JE, Magdic KS. Chest pain: a time for concern? AACN Adv Crit Care. 2014 Jul-Sep;25(3):279-83. [PubMed: 25054533]

7.

Gologorsky R, Hornik B, Velotta J. Surgical Management of Medically Refractory Tietze Syndrome. Ann Thorac Surg. 2017 Dec;104(6):e443-e445. [PubMed: 29153814]

Inflammatory Breast Cancer | Details, Diagnosis, and Signs

Inflammatory breast cancer (IBC) is rare and accounts for only 1-5% of all breast cancers. Although it is often a type of invasive ductal carcinoma, it differs from other types of breast cancer in its symptoms, outlook, and treatment. IBC has symptoms of inflammation like swelling and redness, but infection or injury do not cause IBC or the symptoms. IBC symptoms are caused by cancer cells blocking lymph vessels in the skin causing the breast to look “inflamed.”

Symptoms include breast swelling, purple or red color of the skin, and dimpling or thickening of the skin of the breast so that it may look and feel like an orange peel. Often, you might not feel a lump, even if it is there. If you have any of these symptoms, it does not mean that you have IBC, but you should see a doctor right away.

How is inflammatory breast cancer different from other types of breast cancer?

Inflammatory breast cancer differs (IBC) from other types of breast cancer in several ways:

• IBC doesn’t look like a typical breast cancer. It often does not cause a breast lump, and it might not show up on a mammogram. This makes it harder to diagnose.
• IBC tends to occur in younger women (younger than 40 years of age).
• African-American women appear to develop IBC more often than white women.
• IBC is more common among women who are overweight or obese.
• IBC also tends to be more aggressive—it grows and spreads much more quickly—than more common types of breast cancer.
• IBC is always at a locally advanced stage when it’s first diagnosed because the breast cancer cells have grown into the skin. (This means it is at least stage III.)
• In about 1 of every 3 cases, IBC has already spread (metastasized) to distant parts of the body when it is diagnosed. This makes it harder to treat successfully.
• Women with IBC tend to have a worse prognosis (outcome) than women with other common types of breast cancer.

Signs and symptoms of inflammatory breast cancer

Inflammatory breast cancer (IBC) causes a number of signs and symptoms, most of which develop quickly (within 3-6 months), including:

• Swelling (edema) of the skin of the breast
• Redness involving more than one-third of the breast
• Pitting or thickening of the skin of the breast so that it may look and feel like an orange peel
• A retracted or inverted nipple
• One breast looking larger than the other because of swelling
• One breast feeling warmer and heavier than the other
• A breast that may be tender, painful or itchy
• Swelling of the lymph nodes under the arms or near the collarbone

Tenderness, redness, warmth, and itching are also common symptoms of a breast infection or inflammation, such as mastitis if you’re pregnant or breastfeeding. Because these problems are much more common than IBC, your doctor might suspect infection at first as a cause and treat you with antibiotics.

This may be a good first step, but if your symptoms don’t get better in 7 to 10 days, more tests need to be done to look for cancer. The possibility of IBC should be considered more strongly if you have these symptoms and are not pregnant or breastfeeding, or have been through menopause.

IBC grows and spreads quickly, so the cancer may have already spread to nearby lymph nodes by the time symptoms are noticed. This spread can cause swollen lymph nodes under your arm or above your collar bone. If the diagnosis is delayed, the cancer can spread to distant sites.

If you have any of these symptoms, it does not mean that you have IBC, but you should see a doctor right away. If treatment with antibiotics is started, you’ll need to let your doctor know if it doesn’t help, especially if the symptoms get worse or the affected area gets larger. Ask to see a specialist (like a breast surgeon) or you might want to get a second opinion if you’re concerned.

How is inflammatory breast cancer diagnosed?

Imaging tests

If inflammatory breast cancer (IBC) is suspected, one or more of the following imaging tests may be done:

Sometimes a photo of the breast is taken to help record the amount of redness and swelling before starting treatment.

Biopsy

Breast cancer is diagnosed by a biopsy, taking out a small piece of the breast tissue and looking at it in the lab. Your physical exam and other tests may show findings that are “suspicious for” IBC, but only a biopsy can tell for sure that it is cancer.

Tests on biopsy samples

The cancer cells in the biopsy will be examined in the lab to determine their grade.

They will also be tested for certain proteins that help decide which treatments will be helpful. Women whose breast cancer cells have hormone receptors are likely to benefit from treatment with hormone therapy drugs.

Cancer cells that make too much of a protein called HER2 or too many copies of the gene for that protein may be treated by certain drugs that target HER2.

Stages of inflammatory breast cancer

All inflammatory breast cancers start as Stage III (T4dNXM0) since they involve the skin. If the cancer has spread outside the breast to distant areas it is stage IV. 

For more information, read about breast cancer staging.

Survival rates for inflammatory breast cancer

Inflammatory breast cancer (IBC) is considered an aggressive cancer because it grows quickly, is more likely to have spread at the time it’s found, and is more likely to come back after treatment than other types of breast cancer. The outlook is generally not as good as it is for other types of breast cancer.

Survival rates can give you an idea of what percentage of people with the same type and stage of cancer are still alive a certain amount of time (usually 5 years) after they were diagnosed. They can’t tell you how long you will live, but they may help give you a better understanding of how likely it is that your treatment will be successful.

Keep in mind that survival rates are estimates and are often based on previous outcomes of large numbers of people who had a specific cancer, but they can’t predict what will happen in any particular person’s case. These statistics can be confusing and may lead you to have more questions. Talk with your doctor about how these numbers may apply to you, as he or she is familiar with your situation.

What is a 5-year relative survival rate?

A relative survival rate compares women with the same type and stage of breast cancer to women in the overall population. For example, if the 5-year relative survival rate for a specific stage of breast cancer is 70%, it means that women who have that cancer are, on average, about 70% as likely as women who don’t have that cancer to live for at least 5 years after being diagnosed.

Where do these numbers come from?

The American Cancer Society relies on information from the SEER* database, maintained by the National Cancer Institute (NCI), to provide survival statistics for different types of cancer.

The SEER database tracks 5-year relative survival rates for breast cancer in the United States, based on how far the cancer has spread. The SEER database, however, does not group cancers by AJCC TNM stages (stage 1, stage 2, stage 3, etc.). Instead, it groups cancers into localized, regional, and distant stages:

• Localized: There is no sign that the cancer has spread outside of the breast.
• Regional: The cancer has spread outside the breast to nearby structures or lymph nodes.
• Distant: The cancer has spread to distant parts of the body such as the lungs, liver or bones.

5-year relative survival rates for inflammatory breast cancer

(Based on women diagnosed with inflammatory breast cancer between 2009 and 2016.)

Understanding the numbers

• Women now being diagnosed with inflammatory breast cancer may have a better outlook than these numbers show. Treatments improve over time, and these numbers are based on women who were diagnosed and treated at least four to five years earlier.
• These numbers apply only to the stage of the cancer when it is first diagnosed. They do not apply later on if the cancer grows, spreads, or comes back after treatment.
• These numbers don’t take everything into account. Survival rates are grouped based on how far the cancer has spread, but your age, overall health, how well the cancer responds to treatment, tumor grade, and other factors can also affect your outlook.

*SEER = Surveillance, Epidemiology, and End Results 

Treating inflammatory breast cancer

Inflammatory breast cancer (IBC) that has not spread outside the breast or nearby lymph nodes is stage III. In most cases, treatment is chemotherapy first to try to shrink the tumor, followed by surgery to remove the cancer. Radiation is given after surgery, and, in some cases, more treatment may be given after radiation. Because IBC is so aggressive, breast conserving surgery (lumpectomy) and sentinel lymph node biopsy are typically not part of the treatment.

IBC that has spread to other parts of the body (stage IV) may be treated with chemotherapy, hormone therapy, and/or with drugs that targets HER2.

For details, see Treatment of Inflammatory Breast Cancer.

90,000 Burning sensation behind the breastbone – causes of appearance, under what diseases it occurs, diagnosis and treatment methods

IMPORTANT!

The information in this section cannot be used for self-diagnosis and self-medication. In case of pain or other exacerbation of the disease, only the attending physician should prescribe diagnostic tests. For a diagnosis and correct treatment, you should contact your doctor.

Burning sensation behind the breastbone: causes of appearance, in what diseases it occurs, diagnosis and methods of treatment.

Definition

Burning behind the breastbone is a symptom characteristic of many diseases – this is how patients with pathologies of the cardiovascular system, spine, gastrointestinal tract, respiratory system, neuralgia and panic attacks describe their feelings.

In some cases, this symptom is not dangerous, but some pathological conditions require immediate medical attention.

Varieties of burning behind the breastbone

There is no generally accepted classification of a burning sensation behind the breastbone.When patients are asked about their feelings, they talk about pressing, pulling, stabbing, burning, girdling pain.

Thus, the burning sensation is as varied as the causes that cause it.

Possible causes of a burning sensation behind the breastbone

A burning sensation in the sternum, a feeling of fullness and heaviness, especially in older people, can be a symptom of serious cardiac problems, all of which equally require seeking medical attention.

In diseases of the gastrointestinal tract, the burning sensation, as a rule, is diffuse, often radiating to the back. In many patients, it occurs during or after a meal.

Disruption of the musculoskeletal system often leads to discomfort in the chest. The burning sensation increases with inhalation or exhalation, changes with a change in body position.

Osteochondrosis of the thoracic spine can cause numbness of the hands, a decrease in their sensitivity.

Neuroses, panic attacks are often accompanied by a burning sensation behind the breastbone.

In violation of the neuroendocrine regulation of internal organs, patients complain of a burning sensation behind the breastbone. The reason can be both insufficient maturity of body systems in adolescence, and transferred infectious diseases, stress, bad habits, overwork. A short-term vasospasm leads directly to the appearance of unpleasant sensations in the region of the heart. The attacks pass at rest, accompanied by weakness, palpitations, cold hands due to impaired blood flow.

Diseases leading to a burning sensation behind the breastbone

Cardiovascular pathologies:

1. Angina pectoris. Violation of blood circulation in the vessels of the heart due to atherosclerosis leads to a deterioration in the nutrition of the heart muscle. With physical exertion, excitement, the heart needs more oxygen – if it is not enough, then the first signal will be unpleasant sensations in the chest area. A burning sensation, a squeezing sensation, tingling sensation can radiate (radiate) to the left hand, under the scapula, rarely to the lower jaw, lasting no more than 15 minutes and passing at rest and after taking nitroglycerin.
2. Myocardial infarction. With a heart attack, a sharp violation of the blood supply to the heart muscle occurs due to blockage by thrombotic masses of most of the lumen of the vessel supplying the heart. Most often, intense pain occurs, but there may also be a strong burning sensation in the chest. The attack lasts a long time, does not stop with nitroglycerin, does not go away at rest, is accompanied by shortness of breath, severe weakness, decreased vision.

   Myocardial infarction is a life-threatening condition, so the patient needs urgent hospitalization.

3. A sharp rise in blood pressure may occur with a burning sensation behind the breastbone. During a hypertensive crisis, the patient feels weakness, headache, dizziness, nausea, flies before the eyes and tinnitus.
4. Inflammatory processes in the heart can also be manifested by a burning sensation behind the breastbone. Usually, this condition is preceded by an infectious disease, most often of viral origin, or a severe contusion of the chest area.Unpleasant sensations can spread to the right or left side, intensify with a change in body position.
5. A very formidable condition – pulmonary embolism. It occurs if there are blood clots in the vessels of the lower extremities – breaking off, they rise up the bloodstream and clog the pulmonary vessels. In addition to a burning sensation behind the breastbone, the patient is worried about severe shortness of breath, cough (sometimes with blood), pronounced cyanosis appears. In such a situation, emergency hospitalization is necessary.

   At risk are patients with varicose veins, smokers, patients on the first day after surgery.

Diseases of the gastrointestinal tract:

1. Esophageal pathology is perhaps the most common cause of burning in the chest. It occurs as a result of the throwing of acidic gastric contents into the esophagus, which leads to damage to its mucous membrane. A burning sensation appears after eating (especially spicy, fatty, smoked and fried), when wearing tight belts and taking a horizontal position immediately after eating.

2. Inflammatory processes in the pancreas and gallbladder are often accompanied by a burning sensation behind the breastbone. This symptom appears a couple of hours after eating, may be accompanied by nausea, heaviness in the abdomen.

Respiratory diseases:

With inflammation of the bronchi or lungs (bronchitis, pneumonia, pleurisy), in addition to coughing, the patient’s temperature may be disturbed by a burning sensation in the chest.

In addition, diseases characterized by a burning sensation behind the sternum include intercostal neuralgia, osteochondrosis, intercostal myositis, vegetative-vascular dystonia.

Which doctor should I contact if there is a burning sensation behind the breastbone

If the burning sensation behind the breastbone is accompanied by a sharp deterioration in the condition, weakness, an increase in pain syndrome, the appearance of shortness of breath, cough, dizziness, you must immediately call an ambulance.

In other cases, you should also not postpone a visit to the doctor. Since this symptom has many causes, it is advisable to first turn to
to a therapist. He will prescribe examinations and, if necessary, refer to other specialists: cardiologist; gastroenterologist; pulmonologist; neurologist.

Diagnostics and examinations with a burning sensation behind the breastbone

The diagnosis begins with a thorough history taking, taking into account all the patient’s complaints and with a physical examination.

To rule out cardiovascular disease, chest x-rays or CT scans of the chest and mediastinum, as well as an electrocardiographic study (ECG) or echocardiography (echocardiography), are performed first.

Tietze Syndrome

Date of publication: 04 March 2019 .

Klimovich A.E., Kardis V.I.

Titze’s syndrome (costochondral syndrome, costal chondritis) is a disease from the group of chondropathies, accompanied by aseptic inflammation of one or more upper costal cartilages in the area of ​​their articulation with the sternum.

Manifested by local soreness at the site of the lesion, aggravated by pressure, palpation and deep breathing. As a rule, it occurs for no apparent reason, but in some cases there may be a connection with physical exertion, operations in the chest area, etc.e. The disease is often encountered in clinical practice, but it is one of the little-known. Tietze’s syndrome does not pose a danger to the patient’s life. The prognosis is favorable. If this pathology is suspected in adults, it is necessary to exclude more serious causes of chest pain. Treatment is conservative.

Symptoms of Tietze Syndrome:

Morphological changes are localized in the cartilage of the II, III or IV rib, which is hypertrophied or unusually curved.Histochemically, pathological changes are not observed in it, but sometimes there is a slight edema or nonspecific chronic inflammation in the tissues surrounding the cartilage. The disease usually develops at the age of 20-40 years, although an earlier onset is recorded – at the age of 12-14 years. According to most authors, men and women suffer equally often, but some researchers note that in adulthood, Tietze syndrome is more often detected in women.

Characterized by the appearance of acute or gradually increasing pain in the upper chest, usually on one side.Sometimes this is preceded by a minor trauma. The pain can be very intense, radiate to the shoulder or arm, and intensify with movement.

When viewed in the area of ​​the affected costal cartilage, severe pain and a clear dense spindle-shaped swelling 3-4 cm in size are determined, which confirms the diagnosis. In no other disease (rheumatoid arthritis, spondyloarthritis, fibrositis, etc.), in which the osteochondral joints can be affected, is such a dense swelling of the costal cartilage found.

Diagnosis of Tietze Syndrome:

The X-ray picture is not very typical and may even be normal with a single examination. However, with dynamic observation, it is possible to establish a violation of the calcification of the affected cartilage (premature calcification), the appearance of calcareous and bone lumps along the edges of the cartilage, and its thickening. After a few weeks, the picture changes, which brings confidence in the correctness of the diagnosis and makes it possible to exclude the normal anatomical variant of the calcification of the costal cartilage.At the anterior end of the bone rib, slight periosteal layers appear, and the rib thickens moderately. The intercostal space is therefore narrowed. In the future, the bone and cartilaginous segments of the rib merge together, deforming osteoarthritis develops in the costo-sternum joint, sometimes with significant bone growths.

In doubtful cases, computed tomography is shown, which allows you to detect changes characteristic of Tietze’s syndrome at earlier stages.Also, in the course of differential diagnosis with malignant neoplasms, Tc and Ga scanning and puncture biopsy can be performed, in which degenerative changes in cartilage and the absence of tumor elements are determined.

The process lasts from several weeks to several years and often ends in spontaneous remission. In the differential diagnosis of Titze’s syndrome, it is necessary to exclude not only rheumatic diseases (fibrositis, spondyloarthritis, rheumatoid arthritis), trauma, but also intercostal neuralgia (in favor of Titze’s syndrome is evidenced by less pronounced pain syndrome, the presence of dense swelling in the rib cartilage and the absence of numbness along the course intercostal space) and pathology of the cardiovascular system, in particular ischemic heart disease, as well as diseases of other internal organs.

Much more often, chest pain and palpation of tenderness of individual ribs, corresponding to the localization of spontaneous pain, in the absence of signs of hypertrophy of the costal cartilage, are a manifestation of another benign disease – costochondritis. Pain in the xiphoid process of the sternum, aggravated by pressure on it, may be a sign of isolated xyphoidalgia.

Tietze Syndrome Treatment:

Patients are on outpatient supervision, inpatient treatment is usually not required.

In the treatment, ointments and gels containing non-steroidal anti-inflammatory drugs are used topically. Compresses with Dimexide are also used. With severe pain syndrome, NSAIDs and painkillers for oral administration are prescribed.

In case of persistent pain in combination with signs of inflammation that cannot be stopped by taking analgesics and non-steroidal anti-inflammatory drugs, local novocaine blockades of intercostal nerves or parachondral injections of hydrocortisone provide a good effect.In addition, physiotherapy, reflexology and manual manipulation are used.

It is extremely rare, with the persistent course of the disease and the ineffectiveness of conservative therapy, surgical treatment is required, which consists in subperiosteal resection of the rib. Surgical intervention is performed under general or local anesthesia only in a hospital setting.

Intercostal neuralgia – prices for treatment, symptoms and diagnosis of intercostal neuralgia in the “CM-Clinic”

Since the symptoms of intercostal neuralgia can be a signal of the presence of a number of other diseases (including cardiovascular diseases), it is necessary to undergo a comprehensive diagnosis by a specialized neurologist.

It is impossible to independently determine the pathology, since there are usually several possible causes of the development of the disease at once, and to determine the true cause, the specialist must have sufficient experience, and the clinic must have good laboratory and instrumental equipment.

At the first visit, the doctor interviews the patient, examines the anamnesis, then conducts a general examination. The examination allows the specialist to determine the localization of pain, identify a violation of sensitivity, and also assess the patient’s protective posture.All this allows the neurologist to make a preliminary diagnosis and direct the patient to the necessary examinations in order to confirm the hypothesis put forward.

Methods of diagnostic examination used in the “SM-Clinic”:

• CT or MRI – highly informative methods of instrumental diagnostics, allowing to obtain layer-by-layer images of tissues and anatomical structures of the body. The study is prescribed to determine the location of the nerves, the presence of neoplasms and signs of destruction in the myelin sheath of the nerves.
• ECG is a high-precision method for studying the activity of the heart muscle. Diagnostics is prescribed in order to exclude cardiovascular pathologies (symptoms may be similar to the manifestations of neuralgia).
• Ultrasound of the heart and abdominal organs – ultrasound scanning, which makes it possible to exclude the presence of pathologies in the organs that can manifest themselves with symptoms similar to neuralgia.

In addition, other research methods may be required that are not primarily associated with nerve pathology.For example, gastroscopy is a technique that examines the functioning of the stomach and the presence of pathological processes in it that cause pain.

What is chest myositis and how does it arise? What muscles are affected?

Myositis of the muscles of the chest is an inflammatory process in the muscles of the chest, in which painful lumps (are foci of inflammation) and pain occur. The rib cage is an anatomical structure that consists of the sternum, ribs, spine, and associated muscles.Myositis is an inflammatory process that by definition affects muscle tissue. Although, in some cases, it can spread to other places, for example, to the pleura – a film of connective tissue that lines the chest from the inside.

Why does myositis of the pectoral muscles occur?

Various diseases can lead to the inflammatory process. Root reasons:

• Infections, among which influenza and ARVI are leading. In this case, myositis is considered as a complication of an infectious disease.
• Parasitosis. Parasites that live in the body can also cause breast myositis. But this rarely happens.
• Poisoning with certain substances. Another rather rare reason.
• Features of the profession. Some people are forced to stay in poses for a long time that damage the pectoral muscles and develop inflammation in them. This category includes violinists, pianists, drivers.
• Muscle injuries. Common causes: mechanical injury, frequent convulsions.
• Bacterial infection. Causes the most severe form of myositis, when a focus of purulent inflammation occurs in the muscle tissue. This is manifested by severe pain, fever, worsening of the condition, and malaise. The infection can spread to the pleura, lungs, and other organs. The disease can develop after injuries, non-compliance with the rules of asepsis and antiseptics during medical procedures.

When chest pains are concerned, it is difficult to immediately understand what is their cause.Often, the first suspicion falls not on the myositis of the pectoral muscles, but on problems with the heart, spine, intercostal neuralgia. An experienced doctor will be able to understand why the symptoms have arisen and will prescribe the correct treatment.

What are the forms of thoracic myositis?

Thoracic myositis can be acute or chronic. In the acute form of the disease, rather severe chest pains are troubling. If not treated, over time, the course of the pathology becomes chronic.The pain becomes less severe, and the person often ceases to notice it altogether. Aggravation occurs during a cold, a long stay in an uncomfortable position, a change in weather.
Chest myositis can occur on the left or right, or on both sides. When left-sided, it can mimic heart disease.

There are also two specific chronic forms of the disease in which different muscle groups are affected: polymyositis and dermatomyositis.

Treatment of myositis of the chest

The neurologist prescribes the treatment of the disease individually for each patient.
First of all, you need to identify and eliminate the cause. If viruses are to blame, as a rule, specific antiviral treatment is not required. They carry out standard measures for colds, after a while, recovery occurs. They fight bacteria with antibiotics, and parasites with antiparasitic agents. In case of chronic trauma, rest is recommended, then – the correct organization of work and rest.

General principles of treatment of different forms of chest myositis :

• In the acute form of the disease, rest must be ensured.The damaged muscles must be kept warm, usually the chest is wrapped in woolen cloth.
• To relieve pain, pain relievers from the group of non-steroidal anti-inflammatory drugs are used: such as diclofenac, ibuprofen.
• For some forms of myositis, finalgon and other warming ointments have a good effect.
• When the temperature rises, antipyretic drugs are used.
• Physiotherapy, massage, physiotherapy exercises are also used.

With a purulent form of the disease, it is often necessary to resort to surgical treatment: the abscess is opened and cleaned.

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The main manifestations of myositis of the muscles of the chest are pain in the affected muscles and painful lumps, which correspond to the foci of inflammation.The disease can take two forms:

• In acute myositis , symptoms appear quickly, suddenly, usually during infection, after prolonged muscle tension, trauma.
• In the chronic form of , the manifestations increase gradually, it can be the result of untreated acute inflammation in the muscles.

Characteristic symptoms of chest myositis

The main symptom of chest myositis is pain. Its intensity is gradually increasing.Pain sensations intensify during awkward movements, deep breaths, prolonged stay in a tense uncomfortable position. When feeling the chest in the area of ​​the affected muscles, soreness is noted.

Sometimes swelling, swelling, redness of the skin can be found at the site of the lesion. This symptom is most typical for purulent myositis. In this case, the patient feels weakness, malaise, his body temperature rises.

Protective muscle tension occurs – it helps to restrict movement and reduce pain.

Pain in the muscles can go away for several days, but then a relapse occurs, most often it is provoked by infections, hypothermia, trauma, tension.

Affected muscles become weak, with chronic course they decrease in size over time – their atrophy develops.

How is chest myositis diagnosed?

Usually, the first thing the patient gets to see a therapist, because he does not know why he began to worry about chest pain and other symptoms.Suspecting the neurological nature of the disease, the doctor directs the patient for a consultation with a neurologist.

A neurologist will ask you about your symptoms, when and how they occurred, how they changed over time, what you were sick with during your life, what chronic diseases you currently suffer from. A neurological examination will be performed. The doctor will press on specific points on your chest to determine soreness.

Further, to clarify the diagnosis and exclude other diseases, an examination will be assigned, which may include the following diagnostic methods:

• A blood test for enzymes, an increase in the level of which indicates damage to muscle tissue.
• Magnetic resonance imaging, computed tomography, X-ray – help to detect foci of pathological changes in muscles, bones, organs of the chest.
• Electromyography is a study that evaluates the conduction of electrical impulses in muscles.
• Muscle biopsy – the doctor takes a piece of suspicious tissue and sends it to the laboratory for analysis. This helps diagnose certain forms of myositis, such as dermatomyositis.

What diseases are differential diagnostics of signs of chest myositis carried out with?
Similar chest pains and other symptoms described above can occur with other diseases, such as:

• angina pectoris and other heart diseases;
• diseases of the lungs and pleura – a film of connective tissue that covers them;
• intercostal neuralgia;
• osteochondrosis of the thoracic spine.

90,000 Life after a negative test | Articles of the clinic Medservice

For some people who have recovered from COVID-19 (or an infection similar to the course of Covid-19), the hardest part begins after recovery.The absence of the virus in the analysis, unfortunately, cannot guarantee the previous health, well-being and quality of life. Regardless of how the disease proceeded – asymptomatic or the patient was seriously ill for a long time, after recovery, many face a significant deterioration in general well-being and have a number of very characteristic complaints.

Weakness increases throughout the body, fatigue quickly sets in, even moderate physical activity causes difficulties, efficiency decreases, shortness of breath appears and it is difficult to breathe deeply.

This may indicate a deterioration in lung function after pneumonia – when there is a violation of oxygen metabolism in the tissues of the body, which affects the internal organs and structures, in particular, the heart and musculoskeletal system, endocrine and nervous systems.

And if, after a previous illness, weakness, increased fatigue and decreased performance are also accompanied by frequent palpitations, heart rhythm disturbances and chest pains, then myocarditis (inflammation of the heart muscle) can be suspected in the patient.Because one of the most common complications after COVID-19 is vasculitis, inflammation of small vessels.

The virus infects the inner lining of blood vessels, this is accompanied by an increase in blood viscosity and blockage of small vessels formed by clots (thrombi). And the vessels pass throughout the body, which means that such inflammation can appear not only in the heart, but also in any organ. The brain, intestines, kidneys may be affected. The heart is simply one of the most vulnerable spots because it requires good blood supply and nutrition to function properly.

Also, some of those who have been ill have headaches, sweating, hearing loss, problems with appetite, a periodic rise in temperature to 37-37.4 ⁰ C.

Do not think that fatigue and poor health are purely personal feelings. After such a complex disease, even small deviations in well-being require a timely visit to a doctor in order to start the rehabilitation procedure on time.

The doctors of the Medservice clinic have sufficient qualifications and experience to help restore the impaired body functions.

For our patients, according to indications, we repeat a number of blood and urine tests, conduct an ultrasound examination of the heart, daily monitoring of the ECG (Holter), ultrasound of internal organs, for some we repeat X-ray computed tomography of the chest organs, and the treatment is adjusted according to the revealed changes.

The Medservice clinic has developed special rehabilitation programs for patients who have undergone COVID-19.

Taking into account the practical and clinical effectiveness, our doctors have developed an infusion treatment aimed at the speedy recovery of the body as a whole.

If indicated, a sick leave is issued. Detailed information and pre-registration: 550-300, 330-300 .

Read and recover from a viral infection in the article “How to recover from COVID-19”.

X-ray of the sternum – to make an X-ray of the sternum in Nizhny Novgorod

Radiography is a diagnostic tool that allows you to determine abnormalities in the work of the osteoarticular apparatus and internal organs.It is necessary for the prompt diagnosis, differential diagnosis, and identification of complications. A sternum x-ray also helps the doctor choose the tactics of treatment and monitor its effectiveness.

“Alfa-Health Center” – own project of the “AlfaStrakhovanie” group. We provide a full cycle of laboratory diagnostic and consulting services in any, even the most difficult cases. The entire staff of the clinic is rigorously selected in accordance with European standards: doctors with more than 20 years of experience are responsible for the X-ray examination.

Anatomical features

The sternum is an unpaired bone with an elongated shape. X-ray clearly shows that the posterior surface of this bone is, as it were, concave inward, and the front, on the contrary, is curved outward. The location of the sternum is the section of the anterior chest wall.

This flat bone consists of 3 parts: the handle, the body and the xiphoid process. Normally, X-ray should show that all parts of the sternum are connected to each other by cartilaginous layers, which ossify as they age.

Indications for radiography

X-ray of the sternum can be prescribed by an orthopedic traumatologist, surgeon, therapist. X-ray allows:

• to assess the condition of bones and joints;
• to identify injuries to the ribs, collarbones, shoulder blades and the actual sternum;
• to determine the localization of foreign bodies in the projection of the above bones;
• to diagnose congenital pathologies of the development of the sternum or nearby structures.

X-ray can also confirm the presence of primary tumors or metastases and prepare for the upcoming surgical intervention in the sternum.X-rays are used to check the correct placement of the prosthetics. Another purpose of radiography is to provide follow-up examinations during therapy.

X-rays of the sternum in 2 projections are also done in the presence of symptoms of infectious diseases, curvature of the spine, breathing disorders or suspected lung damage. Other indications for an X-ray are discomfort in the chest and upper extremities, and a persistent cough for a long time.X-rays are also performed with severe pain syndrome caused by pathologies of bone development.

What can be seen in the pictures

Sternum X-ray is performed for detailed study:

• conditions of the articular surface;
• contours of bone elements;

90,043 bone structures;

• integrity of bone structures.

Pictures, or radiographs, in the frontal and lateral projection show the width of the joint space and the height of the vertebrae.X-ray is also considered one of the most affordable methods for diagnosing pathological neoplasms in the sternum and detecting foreign X-ray contrast objects.

Contraindications to radiography

X-ray of the sternum in two projections is not performed if the patient is in a serious or inadequate condition. During the X-ray, it is necessary to be in a static position for several seconds. If this condition is not feasible, X-ray is replaced by another study.

It is not recommended to do x-rays for women during the period of bearing a child, especially the first two trimesters. Radiation during an x-ray negatively affects the development of the fetus. During the period of breastfeeding, it is also worth refraining from taking an X-ray.

Make an appointment for an X-ray of the sternum in 2 projections in Nizhny Novgorod

Radiography in the clinic “Alfa-Health Center” is carried out on modern digital equipment. It allows you to minimize radiation exposure during an X-ray and get the result in a few minutes after taking the picture.After the X-ray, you can make an appointment with an orthopedic traumatologist or other specialist for diagnosis and treatment.

Esophagitis

Acute esophagitis is an inflammation of the wall of the esophagus, manifested by pain, especially pronounced when passing food. In the overwhelming majority of cases, it occurs in combination with stomach diseases and usually affects the lower part of the esophagus.

Helicobacter pylori infection or other flora of the esophagus is most often considered the cause of the disease.

The onset of the disease is facilitated by malnutrition, burns, chemicals, polyhypovitaminosis, and extensive infection.

With esophagitis, the body temperature may rise, general malaise is noted, and unpleasant sensations appear along the esophagus during the movement of food. The child may be disturbed by a burning sensation, sometimes a sharp pain in the esophagus. Children are often capricious and refuse to eat for fear of pain after the first sips of food; they may complain of pain in the neck area, belching, often regurgitation, salivation, and swallowing is impaired.

The diagnosis of esophagitis is based on history, characteristic complaints and clinical signs. Often the main method for making a diagnosis is endoscopic examination, but in the acute period it is not done so as not to injure the lining of the esophagus. X-ray contrast study helps to detect signs of impaired motor function of the esophagus and areas of the erosive-ulcerative process.

Chronic esophagitis – chronic inflammation of the esophageal wall.The disease can develop with insufficiently treated acute esophagitis or as a primary chronic process. Chronic esophagitis is accompanied by pain in the chest and in the epigastric region, often combined with gastritis or duodenitis, which gives a variegated clinical picture. Children cannot always clearly explain their feelings. Older children complain of a sore feeling in the chest immediately after swallowing food; pains may also appear that do not depend on food intake, especially while running, jumping or forced breathing.Sometimes pain occurs when lying on the back, they can be in the form of seizures and radiate to the neck, back or heart. In most cases, children also have belching with air or with an admixture of gastric contents after eating and exercising. Older children complain of heartburn, especially in the evening and at night; nausea, vomiting, regurgitation of food, hiccups, drooling, and shortness of breath are also possible. Hiccups usually start after belching and continue for a long time.

During chronic esophagitis, there are periodic exacerbations and remissions.If treatment is started late and the esophagitis progresses steadily, cicatricial changes in the esophagus may form.

The diagnosis of chronic esophagitis is also based on history, clinical symptoms, endoscopic and radiographic findings.

Patients are advised to eat more often in small quantities, the last time they need to eat no later than three hours before bedtime. If pain is expressed, 2-3 tablespoons of a 0.5% solution of novocaine can be given before meals.Rosehip oil, sea buckthorn oil, sunflower oil contribute to the rapid healing of ulcers and erosions of the mucous membrane and the subsiding of the inflammatory process (they are taken 10-15 ml 3-4 times a day after meals).

For esophagitis, all carbonated drinks are prohibited. When eating, one should not rush; slow chewing of food contributes to the separation of saliva, which has an alkaline reaction. To neutralize the acidic contents of the esophagus, antacids are used (magnesium oxide, magnesium trisilicate, aluminum hydroxide, sodium bicarbonate), they are given in combination with astringents that help calm inflammation and restore the mucous membrane (vikalin, vikair, gastrofarm, vinylin, etc.).

Cerucal is prescribed if vomiting is present. In the period of exacerbation of chronic esophagitis and in acute esophagitis, drugs that suppress Helicobacter pylori infection are used – antibiotics, as well as metronidazole.