Afonso João Ribeiro, Soares Diogo, Lopes Daniel Brás, Matos Rui Milheiro, Pinto Rui Peixoto
Departamento de Ortopedia e Traumatologia, Hospital Santa Maria, Porto, Portugal.
Rev Bras Ortop (Sao Paulo). 2021 Mar 31;57(2):345-347. doi: 10.1055/s-0040-1722587. eCollection 2022 Apr.
The differential diagnosis of dorsal thoracic pain can be a challange due to the proximity of the dorsal column to vital organs as well as to its unique anatomy, innervation, and rib joint. The patterns of referred visceral pain require, in most cases, extensive complementary diagnostic tests in order to exclude severe conditions. Referred pain patterns often result in numerous and expensive visceral workups in order to exclude serious conditions, and costovertebral joint osteoarthritis is usually only considered when the origin of the pain remains unexplained. The authors present the case of a 40-year-old man with disabling dorsal pain due to isolated costovertebral osteoarthrosis. The symptomatology was controlled after injection of methylprednisolone guided by computed tomography. This clinical case aims to describe the clinical presentation of a rare entity that should be considered in the differential diagnosis of back pain.
由于背柱靠近重要器官,以及其独特的解剖结构、神经支配和肋关节,胸背部疼痛的鉴别诊断可能具有挑战性。在大多数情况下,牵涉性内脏痛的模式需要进行广泛的补充诊断测试,以排除严重疾病。牵涉性疼痛模式通常会导致大量且昂贵的内脏检查,以排除严重疾病,而肋椎关节骨关节炎通常仅在疼痛来源不明时才会被考虑。作者介绍了一名40岁男性因孤立性肋椎骨关节炎导致致残性背痛的病例。在计算机断层扫描引导下注射甲基强的松龙后症状得到控制。本临床病例旨在描述一种罕见疾病的临床表现,该疾病应在背痛的鉴别诊断中予以考虑。