Skip to main content
Postgraduate Medical Journal logoLink to Postgraduate Medical Journal
. 1992 Aug;68(802):655–659. doi: 10.1136/pgmj.68.802.655

Costovertebral joint dysfunction: another misdiagnosed cause of atypical chest pain.

J F Arroyo 1, P Jolliet 1, A F Junod 1
PMCID: PMC2399550  PMID: 1448407

Abstract

The diagnostic work-up of atypical chest pain frequently leads to invasive procedures. However, this painful symptomatology can sometimes be of benign origin and respond to simple therapeutic manoeuvres. A number of musculoskeletal conditions such as costovertebral joint dysfunctions should be carefully considered. We report five cases in which patient discomfort and high costs could have been avoided if awareness of these conditions had led to a correct diagnosis upon initial physical examination.

Full text

PDF
656

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Arce C. A., Dohrmann G. J. Thoracic disc herniation. Improved diagnosis with computed tomographic scanning and a review of the literature. Surg Neurol. 1985 Apr;23(4):356–361. doi: 10.1016/0090-3019(85)90206-x. [DOI] [PubMed] [Google Scholar]
  2. Benhamou C. L., Roux C., Gervais T., Viala J. F. Costo-vertebral arthropathy. Diagnostic and therapeutic value of arthrography. Clin Rheumatol. 1988 Jun;7(2):220–223. doi: 10.1007/BF02204458. [DOI] [PubMed] [Google Scholar]
  3. Bogduk N., Marsland A. The cervical zygapophysial joints as a source of neck pain. Spine (Phila Pa 1976) 1988 Jun;13(6):610–617. [PubMed] [Google Scholar]
  4. Carette S., Marcoux S., Truchon R., Grondin C., Gagnon J., Allard Y., Latulippe M. A controlled trial of corticosteroid injections into facet joints for chronic low back pain. N Engl J Med. 1991 Oct 3;325(14):1002–1007. doi: 10.1056/NEJM199110033251405. [DOI] [PubMed] [Google Scholar]
  5. Culling R. D., Rice J. H. Corticosteroid injections for chronic low back pain. N Engl J Med. 1992 Mar 19;326(12):834–836. doi: 10.1056/NEJM199203193261213. [DOI] [PubMed] [Google Scholar]
  6. Deyo R. A. Fads in the treatment of low back pain. N Engl J Med. 1991 Oct 3;325(14):1039–1040. doi: 10.1056/NEJM199110033251411. [DOI] [PubMed] [Google Scholar]
  7. Fam A. G. Approach to musculoskeletal chest wall pain. Prim Care. 1988 Dec;15(4):767–782. [PubMed] [Google Scholar]
  8. Herlitz J., Hjalmarson A., Karlson B. W., Nyberg G. Long-term morbidity in patients where the initial suspicion of myocardial infarction was not confirmed. Clin Cardiol. 1988 Apr;11(4):209–214. doi: 10.1002/clc.4960110404. [DOI] [PubMed] [Google Scholar]
  9. Jalovaara P., Rämö J., Lindholm R. Twelfth-rib syndrome simulating intra-abdominal disease. Case report. Acta Chir Scand. 1988 May-Jun;154(5-6):407–408. [PubMed] [Google Scholar]
  10. Lee T. H., Cook E. F., Weisberg M., Sargent R. K., Wilson C., Goldman L. Acute chest pain in the emergency room. Identification and examination of low-risk patients. Arch Intern Med. 1985 Jan;145(1):65–69. [PubMed] [Google Scholar]
  11. Macones A. J., Jr, Fisher M. S., Locke J. L. Stress-related rib and vertebral changes. Radiology. 1989 Jan;170(1 Pt 1):117–119. doi: 10.1148/radiology.170.1.2783263. [DOI] [PubMed] [Google Scholar]
  12. Pearce M. J., Mayou R. A., Klimes I. The management of atypical non-cardiac chest pain. Q J Med. 1990 Sep;76(281):991–996. [PubMed] [Google Scholar]
  13. Raymond C. Chest pain not always what it seems; panic disorder may be cause in some. JAMA. 1989 Feb 24;261(8):1101–1102. [PubMed] [Google Scholar]
  14. Sox H. C., Jr, Margulies I., Sox C. H. Psychologically mediated effects of diagnostic tests. Ann Intern Med. 1981 Dec;95(6):680–685. doi: 10.7326/0003-4819-95-6-680. [DOI] [PubMed] [Google Scholar]
  15. Spence E. K., Rosato E. F. The slipping rib syndrome. Arch Surg. 1983 Nov;118(11):1330–1332. doi: 10.1001/archsurg.1983.01390110076016. [DOI] [PubMed] [Google Scholar]
  16. Wiesel S. W., Tsourmas N., Feffer H. L., Citrin C. M., Patronas N. A study of computer-assisted tomography. I. The incidence of positive CAT scans in an asymptomatic group of patients. Spine (Phila Pa 1976) 1984 Sep;9(6):549–551. [PubMed] [Google Scholar]
  17. Wright J. T. Slipping-rib syndrome. Lancet. 1980 Sep 20;2(8195 Pt 1):632–634. doi: 10.1016/s0140-6736(80)90294-9. [DOI] [PubMed] [Google Scholar]

Articles from Postgraduate Medical Journal are provided here courtesy of BMJ Publishing Group

RESOURCES