Osteoarthritis of the Cervicodorsal Spine (Radiculitis) Simulating Coronary-Artery Disease

Davis, Donald W.; Ritvo, Max

doi:10.1056/nejm194806172382501

Cited by 19 publications

(4 citation statements)

References 14 publications

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“…A chest wall pathology in angina pectoris has been described in early studies [ 17] with a classical description by Davis & Ritvo of osteoarthritis of the cervicodorsal spine simulating coronary artery disease [ 19]. Newer studies have also dealt with this subject in case reports [ 16, 20].…”

Section: Discussionmentioning

confidence: 99%

“…Chest wall abnormalities believed to mimic angina pectoris include osteoarthritis of the cervicodorsal spine, muscle strain, chest wall fibrositis, costosternal syndrome, scoliosis, disc narrowing, and trauma to the chest [ 17–20, 36, 37]. In addition, a myofascial genesis of pain has been suggested [ 38].…”

Section: Discussionmentioning

confidence: 99%

“…Combinations of cardiac and non‐cardiac abnormalities have also been suggested [ 15]. In previous studies and case reports musculo–skeletal disorders have been described as a possible source of pain in patients with presumed angina [ 16–20] but there is a dearth of systematic studies. In order to evaluate the role of the musculo–skeletal apparatus in chest pain of unknown origin we carried out an extensive investigation of the spine and chest wall in patients with angina and a normal coronary angiogram.…”

Section: Introductionmentioning

confidence: 99%

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Musculo–skeletal pathology in patients with angina pectoris and normal coronary angiograms

Fröbert

Fossgreen

Søndergaard‐Petersen

et al. 1999

Journal of Internal Medicine

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Purpose. To evaluate the role of the musculo-skeletal apparatus in patients with angina pectoris despite normal coronary angiograms. Design. A survey of patients and controls investigated by blinded observers. Setting. A tertiary cardiologic referral centre. Subjects. Thirty women and 18 men (mean age 52.9 years) with chest pain of an average duration of 3 years and 11 months were investigated. All had normal resting electrocardiograms. No patients showed evidence of left ventricular hypertrophy or valvular heart disease on echocardiography and all had a normal coronary angiogram. All had left ventricular ejection fraction >50%, and none had signs of coronary vasospasm. Eighteen healthy persons (10 women and eight men, mean age 51.2 years) served as controls. Main outcome measures.The group frequency of chest wall complaints, spinal radiograph and physical examination findings; pressure pain thresholds. Results. The patients had significantly more complaints of pain from the neck, chest, and thoracic spine, and sensations and pain radiating to the arms than the controls. The patients had more degenerative findings on radiograph than the controls, mainly at levels C4-C7. Physical examination showed that abnormal findings were significantly more frequent in patients than in the control group in the anterior and posterior chest wall, in the spine at levels Th1-Th6 and in the muscles of the neck and shoulder girdle. There were no statistically significant differences in pain thresholds or in neurological examination. Conclusion. The musculo-skeletal abnormalities observed in the patients could include reflex mechanisms. Whether the abnormal findings are mainly responsible for the angina pectoris symptoms or merely epiphenomena warrants further study.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Musculo–skeletal pathology in patients with angina pectoris and normal coronary angiograms

Fröbert

Fossgreen

Søndergaard‐Petersen

et al. 1999

Journal of Internal Medicine

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“…Spinal osteoarthritis with nerve root impingement may be difficult to exclude in the age group under consideration [7], and any of our cases of thoracic radiculopathy with even moderate degenerative spinal radiographic findings were attributed to mechanical nerve root compromise. A compressive lesion may coexist in some patients with a diabetic predisposition to nerve root disease [23].…”

Section: Discussionmentioning

confidence: 76%

Thoracic root pain in diabetes: The spectrum of clinical and electromyographic findings

Kikta

Breuer

Wilbourn

1982

Annals of Neurology

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Diabetic thoracic radiculopathy has been reported rarely. Fifteen new cases, seen in an equal number of patients over a 3-year period and confirmed by electromyographic findings, have been analyzed. All patients presented with severe abdominal or chest pain, which often was not radicular in character. The presence of dysesthesias and an abnormal sensory examination of the trunk aided diagnosis. The pain was frequently associated with marked weight loss but carried a good prognosis for recovery. Six additional patients with negative electromyographic examinations were considered to have the disorder. Diabetic thoracic radiculopathy produces a distinct syndrome and may be more common than is generally recognized.

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Chest wall syndrome. A common cause of unexplained cardiac pain

Epstein¹

1979

JAMA: The Journal of the American Medical Association

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Osteoarthritis of the Cervicodorsal Spine (Radiculitis) Simulating Coronary-Artery Disease

Cited by 19 publications

References 14 publications

Musculo–skeletal pathology in patients with angina pectoris and normal coronary angiograms

Musculo–skeletal pathology in patients with angina pectoris and normal coronary angiograms

Thoracic root pain in diabetes: The spectrum of clinical and electromyographic findings

Chest wall syndrome. A common cause of unexplained cardiac pain

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