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Anterior chest pain: musculoskeletal considerations

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Abstract

The clinical symptom of anterior chest pain generally elicits a long list of diagnoses. When cardiac and pleural conditions are excluded, conditions that affect the musculoskeletal system become important considerations. Many of these conditions have characteristic imaging features that allow accurate diagnosis. In others, the imaging findings can be instrumental in directing the appropriate course of action. This article reviews the imaging features of a number of musculoskeletal entities that present with anterior chest pain including traumatic, rheumatologic, inflammatory, infectious, and neoplastic conditions.

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References

  1. Wise CM, Semble EL, Dalton CB (1992) Musculoskeletal chest wall syndromes in patients with noncardiac chest pain: a study of 100 patients. Arch Phys Med Rehabil 73:147–149

    CAS  PubMed  Google Scholar 

  2. Fam AG, Smythe HA (1985) Musculoskeletal chest wall pain. Can Med Assoc J 133:379–389

    CAS  Google Scholar 

  3. Destouet JM, Gilula LA, Murphy WA, Sagel SS (1981) Computed tomography of the sternoclavicular joint and sternum. Radiology 138:123–128

    CAS  PubMed  Google Scholar 

  4. Brossman J, Stabler A, Preidler KW, Trudell D, Resnick D (1996) Sternoclavicular joint: MR imaging—anatomic correlation. Radiology 198:193–198

    PubMed  Google Scholar 

  5. Rand T, Schweitzer M, Rafii M, Nguyen K, Garcia M, Resnick D (1998) Condensing osteitis of the clavicle: MRI. J Comput Assist Tomogr 22:621–624

    CAS  PubMed  Google Scholar 

  6. Baker ME, Martinez, Kier R, Wain S (1988) High resolution computed tomography of the cadaveric sternoclavicular joint—findings in degenerative joint disease. J Comput Assist Tomogr 12:13–18

    CAS  Google Scholar 

  7. Garretson RB, Williams GR (2003) Clinical evaluation of injuries to the acromioclavicular and sternoclavicular joints. Clin Sports Med 22:239–254

    PubMed  Google Scholar 

  8. Carey S, Pezzella AT, Gilliam H (1988) Traumatic sternal fractures: current concepts in diagnosis and management. Milit Med 153:451–453

    CAS  Google Scholar 

  9. Mueller CF, Hummel MM (1994) Sternal fractures: new perspectives. Emerg Radiol 1:52–55

    Google Scholar 

  10. Heyes FLP, Vincent R (1993) Sternal fracture: what investigations are indicated? Injury 24:113–115

    Article  CAS  PubMed  Google Scholar 

  11. Harris JH () In: Harris JH Jr, Harris WH (eds) The radiology of emergency medicine, 4th edn. Lippincott Williams & Wilkins, Philadelphia, pp 437–581

  12. Ferrera PC, Wheeling HM (2000) Sternoclavicular joint injuries. Am J Emerg Med 18:58–61

    Article  CAS  PubMed  Google Scholar 

  13. Gregory PL, Biswas AC, Batt ME (2002) Musculoskeletal problems of the chest wall in athletes. Sports Med 32:235–250

    PubMed  Google Scholar 

  14. Chen C, Chandnani V, Kang HS, et al (1990) Insufficiency fracture of the sternum caused by osteopenia: plain film findings in seven patients. AJR 1 Am J Roentgenol 154:1025

    CAS  Google Scholar 

  15. Henley MB, Peter RE, Bernirschke SK, Ashbaugh D (1991) External fixation of the sternum for thoracic trauma. J Orthop Trauma 5:493–497

    CAS  PubMed  Google Scholar 

  16. Moore RS (1991) Fracture of the first rib: an uncommon throwing injury. Injury 22:149–150

    Article  CAS  PubMed  Google Scholar 

  17. Karlson KA (1998) Rib stress fractures in elite rowers: a case series and proposed mechanism. Am J Sports Med 26:516–519

    CAS  PubMed  Google Scholar 

  18. Warden SJ, Gutschlag FR, Wajswelner H, Crossley KM (2002) Aetiology of rib stress fractures in rowers. Sports Med 32:819–836

    PubMed  Google Scholar 

  19. Kier R, Wain SL, Apple J, Martinez S (1986) Osteoarthritis of the sternoclavicular joint. Radiographic features and pathologic correlations. Invest Radiol 21:227–233

    CAS  PubMed  Google Scholar 

  20. Louvel JP, Duvey A, Da Silva F, et al (1997) Computed tomography of sternoclavicular joint lesions in spondyloarthropathies. Skeletal Radiol 26:419–423

    Article  CAS  PubMed  Google Scholar 

  21. Richman KM, Boutin RD, Vaughan LM, Haghighi P, Resnick D (1999) Tophaceous pseudogout of the sternoclavicular joint. AJR Am J Roentgenol 172:1587–1589

    CAS  PubMed  Google Scholar 

  22. Disla E, Rhim HR, Reddy A, Karten I, Taranta A (1994) Costochondritis: a prospective analysis in an emergency department setting. Arch Intern Med 154:2466–2469

    Article  CAS  PubMed  Google Scholar 

  23. Ikehira H, Kinjo M, Nagase Y, Aoki T, Ito H (1999) Acute pan-costochondritis demonstrated by gallium scintigraphy. Br J Radiol 72:210–211

    CAS  PubMed  Google Scholar 

  24. Mendelson G, Mendelson H, Horowitz SF, et al (1997) Can (99m)-technetium methylene diphosphonate bone scans objectively document costochondritis? Chest 111:1600–1602

    CAS  PubMed  Google Scholar 

  25. Resnick D (1980) Sternoclavicular hyperostosis. AJR Am J Roentgenol 135:1278–1280

    CAS  PubMed  Google Scholar 

  26. Sartoris DJ, Schreiman JS, Kerr R, et al (1986) Sternoclavicular hyperostosis: a review and report of 11 cases. Radiology 158:125–128

    CAS  PubMed  Google Scholar 

  27. Earwaker JWS, Cotton A (2003) SAPHO: syndrome or concept? Imaging findings. Skeletal Radiol 32:311–327

    CAS  PubMed  Google Scholar 

  28. Economou G, Jones PB, Adams JE, Bernstein RM (1993) Computed tomography in sternocostoclavicular hyperostosis. Br J Radiol 66:1118–1124

    CAS  PubMed  Google Scholar 

  29. Brower AC, Sweet DE, Keats TE (1974) Condensing osteitis of the clavicle: a new entity. AJR Am J Roentgenol 121:17–21

    CAS  Google Scholar 

  30. Appell RG, Oppermann HC, Becker W, Kratzat R, Brandeis WE, Willich E (1983) Condensing osteitis of the clavicle in childhood: a rare sclerotic bone lesion. Review of literature and report of seven patients. Pediatr Radiol 13:301–306

    CAS  PubMed  Google Scholar 

  31. Greenspan A, Gerscovich E, Szabo RM, Matthews JG (1991) Condensing osteitis of the clavicle: a rare but frequently misdiagnosed condition. AJR Am J Roentgenol 156:1011–1015

    CAS  PubMed  Google Scholar 

  32. Wohlgethan JR, Newberg AH, Reed JI (1988) The risk of abscess from sternoclavicular septic arthritis. J Rheumatol 15:1302–1306

    CAS  PubMed  Google Scholar 

  33. Gotway MB, Marder SR, Hanks DK, et al (2002) Thoracic complications of illicit drug use: an organ system approach. Radiographics 22: s119–s135

    PubMed  Google Scholar 

  34. Bar-Natan M, Salai M, Sidi Y, Gur H (2002) Sternoclavicular infectious arthritis in previously healthy adults. Semin Arthritis Rheum 32:189–195

    Article  PubMed  Google Scholar 

  35. Tecce PM, Fishman EK (1995) Spiral CT with multiplanar reconstruction in the diagnosis of sternoclavicular osteomyelitis. Skeletal Radiol 24:275–281

    CAS  PubMed  Google Scholar 

  36. Wolfe SW, Wickiewicz TL, Cavenaugh JT (1992) Ruptures of the pectoralis major muscle: anatomic and clinical analysis. Am J Sports Med 20:587–592

    CAS  PubMed  Google Scholar 

  37. Carrino JA, Chandnani VP, Mitchell DB, Choi-Chinn K, DeBerardino TM, Miller MD (2000) Pectoralis major muscle and tendon tears: diagnosis and grading using magnetic resonance imaging. Skeletal Radiol 29:305–313

    Article  CAS  PubMed  Google Scholar 

  38. Connell DA, Potter HG, Sherman MF, Wickiewicz TL (1999) Injuries of the pectoralis major muscle: evaluation with MR imaging. Radiology 210:785–791

    CAS  PubMed  Google Scholar 

  39. Meyer CA, White CS (1998) Cartilaginous disorders of the chest. Radiographics 18:1109–1123

    CAS  PubMed  Google Scholar 

  40. Teitelbaum SL (1969) Tumors of the chest wall. Surg Gynecol Obstet 129:1059–1073

    CAS  PubMed  Google Scholar 

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Authors and Affiliations

  1. Department of Radiology, Ohio State University Medical Center, 633 Means Hall, 1654 Upham Drive, Columbus, OH 43210, USA

    Paula A. Habib, Joseph A. Mendiola & Joseph S. Yu

  2. Department of Radiology, Tri-Service General Hospital, National Defense Medical Center, 325, Section 2, Cheng-Kung Rd., 114, Neihu, Taipei , Taiwan, Republic of China

    Guo-Shu Huang

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  1. Paula A. Habib
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  2. Guo-Shu Huang
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  3. Joseph A. Mendiola
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  4. Joseph S. Yu
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Correspondence to Joseph S. Yu.

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Habib, P.A., Huang, GS., Mendiola, J.A. et al. Anterior chest pain: musculoskeletal considerations. Emerg Radiol 11, 37–45 (2004). https://doi.org/10.1007/s10140-004-0342-7

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  • DOI: https://doi.org/10.1007/s10140-004-0342-7

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