Yaari, Shaul and Juravel, Elchanan and Daana, Murad and Heyman, Samuel N (2020) Pleurisy Can Cause Chest Wall Tenderness: A Case Report. European Journal of Case Reports in Internal Medicine, 7 (10). pp. 1-3. ISSN ISSN: 2284-2594
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Abstract
Stab-like localized chest pain, aggravated by breathing, is compatible with pleuritic pain or with aching related to chest wall abnormalities. Local tenderness inflicted by palpation helps to differentiate pleuritic from musculoskeletal chest pain and serves as a principal accessory manoeuvre in the algorithm of chest pain evaluation. Herein, we report the case of a 27-year-old patient with pulmonary thromboembolism and right lower lobe consolidation/atelectasis. The patient presented with right-sided chest pain, radiating to the shoulder, related to pleural irritation, yet associated with confounding intense chest wall tenderness and guarding, also involving the costovertebral angle. We propose that spinal reflex-related chest wall tenderness was involved, similar to peritoneal signs evoked by irritation of the parietal peritoneum. This case report illustrates that localized chest wall tenderness and guarding, triggered by palpation, may not serve as unequivocal indicators of musculoskeletal pain, and could be unrecognized features of pleuritic chest pain also.
| Item Type: | Article |
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| Uncontrolled Keywords: | Pulmonary embolism, chest pain, pleura, symptoms, physical examination |
| Subjects: | 600 Tecnologia - Scienze applicate 600 Tecnologia - Scienze applicate > 610 Medicina e salute (Classificare qui la tecnologia dei servizi medici) 600 Tecnologia - Scienze applicate > 610 Medicina e salute (Classificare qui la tecnologia dei servizi medici) > 616 Malattie (classificare qui la Clinica medica, la medicina basata sull'evidenza, la Medicina interna, la Medicina sperimentale) |
| Depositing User: | Marina Spanti |
| Date Deposited: | 15 Dec 2021 13:37 |
| Last Modified: | 15 Dec 2021 13:37 |
| URI: | http://eprints.bice.rm.cnr.it/id/eprint/21017 |
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