Thoracic disc prolapse presenting with abdominal pain: case report and review of the literature

Papadakos, Nikolaos; Georges, Husam; Sibtain, Naomi; Tolias, Christos M.

doi:10.1308/147870809x401038

Cited by 16 publications

(13 citation statements)

References 12 publications

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“…As Papadakos et al noted: "Due to the rarity of this condition, the presenting symptoms are often attributed to pulmonary, cardiac, gastrointestinal or genito-urinary causes. This can lead to unnecessary investigations and procedures" [11]. The upper thoracic spine is vulnerable to mechanical dysfunction secondary to degenerative changes, prolonged faulty posture and muscle weakness.…”

Section: Discussionmentioning

confidence: 99%

Mastalgia Due to Degenerative Changes of the Spine

Pırtı¹,

Barlas²,

Kuru³

et al. 2016

Adv Clin Exp Med

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people, and the prevalence increases in the fifth decade of life. Cervical radiculopathy is the result of cervical nerve root pathology, often caused by space-occupying lesions such as cervical disc herniation, spondylosis, or osteophytosis. These space-occupying lesions produce upper extremity radicular symptoms such as pain, numbness, weakness and paresthesia. The C6 and C7 nerve roots are most commonly involved in cervical radiculopathy [3].The aim of the present study was to define the incidence of vertebral pathologies in patients with non-cyclic mastalgia and the efficacy of conservative treatment of these pathologies on relieving breast pain. Mastalgia, which is the reason for 50% of all referrals to breast clinics, affects up to 75% of women during their lives. It is a common and enigmatic condition, the cause and optimal treatment of which are still inadequately defined. It may be severe enough to affect the patient's usual daily activities, and its effect on quality of life is often underestimated. Evaluations of breast pain vary depending on whether it is classified as cyclic mastalgia, noncyclic mastalgia or extramammary pain. This distinction is important because the evaluation and the response to interventions vary among the different types of breast pain [1,2].Cervical radiculopathy is frequently encountered, with an annual incidence of 83. AbstractBackground. Mastalgia is a common and enigmatic condition; the cause and optimal treatment are still inadequately defined. Cervical radiculopathy, which is the result of cervical nerve root pathology often caused by spaceoccupying lesions such as cervical disc herniation, spondylosis, or osteophytosis, is frequently encountered in physical therapy. Objectives. The aim of the study was to evaluate the incidence of vertebral pathologies in patients with non-cyclic mastalgia and the efficacy of conservative treatment of these pathologies on relieving breast pain. Material and Methods. One hundred patients were included in the study, all with breast pain continuing throughout the day and lasting at least three months. Breast and axillary physical examinations, mammographic and/or ultrasonographic evaluations were normal in all the patients. The patients' pain levels were scored using a visual analog scale (VAS). Cervical and thoracic spine magnetic resonance imaging (MRI) was performed on all the participants. Results. Among 96 patients that had pathological findings on magnetic resonance imaging (96%), 49 women had diffuse annular bulging of the cervical spine, and 47 had cervical disc protrusion. Additionally, 12 patients had thoracic disc protrusion. At the end of the three-month period, the patients who were given only conservative treatment returned for follow-up evaluations. According to the VAS scores, five patients had mild to moderate improvement, 55 showed significant improvement, and 29 achieved complete remission. Conclusions. The authors concluded that if none of the known causes of breast pain are found in a patient, the patient should be eva...

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Section: Discussionmentioning

confidence: 99%

Mastalgia Due to Degenerative Changes of the Spine

Pırtı¹,

Barlas²,

Kuru³

et al. 2016

Adv Clin Exp Med

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“…7,8 Though thoracic spine problems are a rare cause of pain abdomen but the clinician should be aware of it while forming a diagnosis. 9…”

Section: Discussionmentioning

confidence: 99%

Thoracic Facet Arthropathy Presenting with Pain Abdomen: An Unusual Presentation

Meraj

Das

2016

Journal on Recent Advances in Pain

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This case report is about a patient with thoracic facet arthropathy presenting with abdominal pain, who underwent multiple investigations and treatment for abdominal visceral conditions with no relief of his pain. A 29 years male presented to our pain clinic with episodic, severe left chest wall, and upper abdominal pain. In the last 4 years, he had been treated for various abdominal visceral conditions. He was then diagnosed as a case of intercostal neuralgia and 12th rib (the twelfth rib syndrome). He was treated with anticonvulsants and antidepressants, as well as intercostal nerve block, tender point injection and intercostal nerve radiofrequency (RF), but with partial relief. Careful history and clinical examination revealed left lower thoracic facet joint involvement. Diagnostic block of medial branch of left 10, 11 and 12th thoracic dorsal rami was done with 90% pain relief. This case emphasises that in any case of abdominal pain, spine should be examined because referred pain from spine can be an important etiology of pain abdomen. Careful history, examination and appropriate investigations should be done to rule out abdominal pathologies, and to arrive at a diagnosis. A thorough history, meticulous examination, and diagnostic blocks if required are very important to localize the pain generators.

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“…Thoracic disc prolapse is uncommon, with reported incidences between 0.15% to 4% of all symptomatic disc prolapses [1,2]. The most common level of prolapse is T11/T12, and calcification occurs in 65% of patients [2].…”

Section: Discussionmentioning

confidence: 99%

“…The most common complaint is that of back pain, with or without a radicular component. Abdominal and groin pain are a rare but recognised entity and diagnosis of a thoracic disc prolapse in these patients usually follows multiple non-invasive and invasive procedures such as endoscopy and laparoscopy [1,[3][4][5][6][7].The mechanism of abdominal pain is unclear. Visceral and somatic afferent fibres are attributed to different spinal locations and there is no relationship between visceral afferents and dermatome level, although the lower thoracic nerves (T8-T12) appear to be most commonly involved with patients who present with abdominal pain [1,[4][5][6].…”

Section: Discussionmentioning

confidence: 99%