Bone necrosis in the chest

Steroid mastoid tumor is a degenerative lesion of the spine (deterioration and destruction of the bony structure of the vertebrae). It begins with a postural lesion, the appearance of autonomic symptoms (dyspnea, weakness, sweating, malaise) and the development of a severe pain syndrome. Therefore, thoracic osteonecrosis mimics cardiovascular diseases, thus requiring accurate differential diagnosis. Therapy includes a variety of treatments: medication, exercise therapy, physical therapy, and massage.

Steroid mastoid tumors are less common than cervical or lumbar fibroids. This is due to the specifics of the anatomical structure. The vertebral discs in the thoracic region make up two-thirds of the entire spine and they are also larger in diameter, but smaller in size than the lumbar region. This area is strong and of low mobility, protected by the ribcage and ribs. Physiological curvature towards the back. This leads to increased stress on the anterior part of the spine. Furthermore, the formation and growth of pathological bony structures on the vertebral body (osteogenesis) occurs. Peripheral nerve endings are located between ligaments and muscle tissue, their tension leads to compression with the development of pain.

There are also multi-segment lesions of the spine with osteonecrosis. At the same time, degeneration of the neck, thoracic and lumbar regions is associated with corresponding clinical symptoms.
The clinical symptoms of thoracic osteonecrosis between women and men are almost the same and there is no significant difference.

Popularity

Diagnosis can be made at any age. This disease is common in adolescents with weak musculoskeletal systems, as well as due to the active development of children. Pathology often forms in pregnant women due to a pronounced load on the thoracic region during pregnancy.

Everyone has a predisposition to the development of osteonecrosis of the thoracic region. This is due to a person's upright posture and as a result, the spine is subjected to a large load.

Classify

Chest pain syndrome is characterized by severe chest pain of an intense nature. The syndrome is associated with peripheral nerve damage. Success or failure is caused by nerves being compressed by muscles and ligaments.

Degree of thoracic bone necrosis:

• The first degree is characterized by the absence of pronounced clinical manifestations. The discs lose their elasticity and form their protrusions.
• The second degree is marked by a gradual loss of elasticity of the intervertebral discs and a decrease in their height. The possibility of a hernia is increased. Pain syndrome occurs, concomitant pain symptoms may occur.
• In the third degree, the pain syndrome increases. The appearance of a herniated disc located between the vertebrae is quite possible. The severity of symptoms depends on the location of the hernia.
• Fourth degree with complete violation of the elasticity and loss of function of the discs, destruction of the bony structure of the vertebrae. Neurological disorders are most evident.

According to the type of pain symptoms:

• Pain in the thoracic vertebrae is justified by pathology of the spine.
• Unexplained thoracic pain is caused by the formation of pathologies of internal organs: cardiovascular diseases, gastroduodenal reflux, trauma and inflammatory lesions of the musculoskeletal system.
• Psychological thoracic pain caused by panic attacks and damage to organs of nervous origin.

Causes and risk factors

Osteosarcoma does not form without damaging factors. Several reasons or a combination of them lead to the development of diseases in the chest area.

• Sedentary lifestyle. Lack of physical activity leads to muscle weakness of the back and disc segments. Sedentary work and improper workplace organization act as an additional factor leading to thoracic osteonecrosis.
• Improper weight lifting and various types of injuries. Excessive stress disrupts the functioning of the spine. In this situation, the muscles and discs cannot bear the load.
• Acquired lesions and curvature of the spine. Against the background of these pathologies, the work of the spine is disrupted, and the likelihood of osteonecrosis formation increases. Destruction will increase if the doctor's recommendations are not followed.
• Lack of essential minerals and vitamins. With insufficient calcium levels in bone tissue, bones become weaker, and the potential for musculoskeletal damage increases.
• Pregnancy is a combination of main factors: an increased load on the spine and a lack of minerals and vitamins.

Important!Genetic predisposition plays an important role. If the lesions of the musculoskeletal system are observed in a related way, then you should be careful about your health and prevent injuries. A competent system of preventive measures prevents massive destruction of bone tissue.

Who is at risk?

Often the factors for the formation of degenerative changes in the spine are combined.

• The reduced immune status associated with higher susceptibility to infections may increase the clinical manifestations of myositis-induced osteonecrosis.
• Stress influences can cause thoracic neuralgia. This is due to the release of more catecholamines, which increase pain.
• Damage to the nervous system of non-infectious and infectious etiology.
• Physical overload.
• Non-compliance with ergonomics (carrying weight) guidelines.
• Spinal injuries have different origins.
• Muscle spasm.
• Osteoarthritis of the musculoskeletal system.

The symptoms

The leading symptoms of thoracic osteonecrosis

• Burning sensation arises in the intercostal spaces.
• Paroxysmal and persistent pain in the chest, primarily a stabbing sensation.
• With angina, the syndrome of stabbing pain, spasms and aches.
• Stomachache.
• Pain on one side of the trunk.
• During movement, the crackling sound of the vertebrae is noted.
• The pain symptoms increase dramatically with movement, taking deep breaths, coughing and sneezing, which is the leading difference between thoracic osteochondrosis and angina pectoris.
• The affected areas are palpable, that is, they can be felt and are located along the affected nerves.
• The skin is numb along the intercostal spaces.
• The patient's condition worsens with exposure to low temperatures or being in an uncomfortable position for long periods of time.

Pain syndromes in osteonecrosis of the thoracic spine:

• Injury to the lower neck. Pain in the upper chest, which may radiate down the neck, arm, and left half of the body.
• Injury to the upper thoracic spine. The pain is sharp in nature, affecting the central part of the chest. Often associated with pain in the shoulder area.
• The defeat of the border zone. Pain symptoms are of a cutting, aching and stabbing nature. There is the appearance of attacks, both long and short. It occupies the lateral region, and is also concentrated in the shoulder blade region.
• The appearance of pain in the anterior chest wall, varying in duration. They arise between the peri-thoracic lines and the anterior axillary line.

In addition to the leading signs, there are two types of pain syndromes in thoracic osteonecrosis:

• Dorsago - severe, but short-term pain at the localization of the affected discs. Normal breathing disturbances.
• Back pain - mild, but persistent pain in the affected disc area.

Chest pain due to spondylosisassociated with damage to the musculoskeletal system, often accompanied by severe pain and instability of the vertebrae of the thoracic spine (increasing their mobility). The failure is manifested in a violation of mobility of the thoracic spine, sutures and cuts in the intercostal spaces.

Thoracic vertebra painMay cause the following symptoms:

• lens (pain symptoms);
• visceral violations of the thoracic region (visceral manifestations: some patients have painful symptoms of a knife-like nature in the gastrointestinal tract or cardiovascular system);
• lens syndrome with vegetative signs (intercostal pain).

When diagnosing a problem, it is important to distinguish symptoms from cardiovascular disease and muscle pain. Cardiac injury due to ischemic etiology is distinguished by how often it occurs under physical or psycho-emotional stress and by the relief of pain with nitrates.

A thoracic neuralgia is accompanied by panic, anxiety, suffocation, and psychosis. It turns out that this disease is the result of psychological stability problems.

The clinical signs of osteonecrosis are divided into two main parts:

1. Neurological symptoms:
   • With thoracic osteonecrosis, numbness and tingling may occur both in the upper extremities and along the intercostal spaces, extending to the anterior surface of the chest.
   • The pectoral and pectoral muscles are in constant tension.
   • Emotionally volatile, tearful and irritable.
   • In rare cases, the disease presents with marked intercostal neuralgia.
2. Types of pain sensations:
   • Low back pain: sharp, acute pain in the thoracic spine, sometimes causing difficulty breathing. Movement in the cervical spine and chest is limited. It manifests itself or gets worse when sitting in a twisted position.
   • Back pain: the development of painful symptoms takes two to three weeks, therefore, at first it progresses without clinical manifestation for the patient. There is a slight discomfort in the chest. The pain is worse when turning to the sides and taking deep breaths. With the final stabilization of the pathological process, a persistent pain syndrome is formed.
   • Intercostal neuralgia: intermittent pain radiating along the intercostal spaces. When you take a strong breath, a sharp pain appears in the heart area. As a result, the pathology is often confused with damage to the cardiovascular system.
   • Cardiac or pseudo-chest syndrome is formed with lesions at the level of the THI segments with the development of reflex angina attacks. The difference from organ damage to the cardiovascular system is that pain occurs when bending or rotating the spine. They strengthen when in a forced pose for a long time. Pain is felt when palpable spinous processes in the thoracic spine.
   • Lens syndrome: intercostal pain (Erb score).
   • Visceral syndrome: dysfunction of the abdominal organs with lesions at the level of the V-XII thoracic vertebrae. It is manifested by abdominal pain, right hypogastric heaviness, heartburn.

Clinical symptoms depend on the extent of damage to the thoracic spine:

* Failure of nerve processes in the process of bone resorption in the thoracic cavity occurs in the case of the appearance of osteoblasts - the growth of bone on the vertebrae. This is due to the destruction speed. Therefore, the symptoms below are not part of the disease.

• Distortion of neural processes at the Th2 and Th3 levels. Damage to the cardiovascular system occurs with the occurrence of episodes of arrhythmias and coronary heart disease. Therefore, chronic pain symptoms in chest pain can cause organ dysfunction of the cardiovascular system.
• Defeat at Th4-Th5 level. Organs with damaged nerve fibers: pleurisy and bronchitis, pneumonia, bronchial asthma.
• Th5-Th6: biliary tract and gallbladder affected. Fat absorption in the body is reduced.
• Th6-Th7: affects the liver and the solar plexus. The function of the hepatobiliary tract is impaired.
• Th7-Th8: stomach is affected. Main pathologies: duodenal and gastric ulcerative lesions, dyspepsia and gastritis.
• Th8-Th9: changes in the activity of the duodenum and pancreas. Manifestations: duodenitis, pancreatitis and loose stools.
• Th9-Th10: damage to nerve cells of internal organs (spleen and diaphragm). Hiccups and shortness of breath occur.
• Th10-Th11: adrenal glands are affected. The activity of the immune system decreases and allergies appear.
• Th11-Th12: impaired renal function leads to pyelonephritis and urolithiasis.
• Th12-L1 (level of the first lumbar vertebra). Damaged kidneys and ureters. This leads to dysuria - problems urinating.

Diagnosis of thoracic bone tumor

If you suspect osteonecrosis, you can contact a therapist or neurologist.

Patients were examined with all clinical data recorded. During the formation of stages 2-3, the skeleton undergoes significant deformation. A complete history of the patient should be obtained in order to accurately identify or rule out predisposing factors for the formation of osteonecrosis of the thoracic spine.

The first diagnostic method is X-ray. Further studies were performed based on history data and the need for differential diagnosis.
Any physician can do the initial examination of a patient. The main thing is an authoritative and fully collected clinical history. This will allow you to pinpoint the exact cause of the disease and choose a treatment regimen. Therapists, neurologists, and rheumatologists are involved in the treatment of thoracic osteonecrosis. In the case of trauma to the spine area, consultation with a trauma specialist is required.

• Chest X-ray in two screenings. Allows you to set the presence and size of bone cells, to determine the contour and height of the disc, to set the changes in the shape of the disc.
• Disc angiography can examine the structure of the pulp nucleus through the use of contrast media.
• Computed tomography is used to visualize nerve fibers, muscles, ligaments, and joints.
• Electromyography allows differential diagnosis of neurological diseases.
• Endoscopic diagnostic methods may be prescribed for the purpose of examining the circulatory and digestive organs.
• An electrocardiogram is performed to determine the cause of cardiovascular disease.
• Electroencephalographic recording - to establish pathologies of the nervous system.

Differential diagnosis

Thoracic fibroids need to be differentiated from a number of diseases.

• Defects in the formation of the spine, trauma, tumors, inflammation. There are several options for these conditions. For example, a congenital process of addition, displacement or fusion of vertebrae (spondylolisthesis), osteomyelitis, ankylosing spondylitis, and others.
• Injury to the musculoskeletal system (different lengths of the lower extremities, muscle spasms, myositis and others).
• Not associated with damage to the musculoskeletal system, but similar in symptoms of diseases of internal organs. Especially pancreatitis, appendicitis, peptic ulcer disease, coronary heart disease, angina pectoris, pleurisy.
• Nervous-like disorder, associated with migratory pain with increased fatigue, irritability, mood swings

Thoracic osteonecrosis and ischemic heart disease

It is extremely important to conduct an authoritative differential diagnosis with the most similar pathologies. Pain arising from thoracic spondylitis and coronary heart disease (IHD) have some differences, so an accurate diagnosis can be made.

The nature of pain: with coronary artery disease, they have a burning and spasmodic nature, accompanied by a fear of death.

Over time pain:

• IHD: Short term attack, within minutes.
• Osteonecrosis of the chest is characterized by pain that fades or persists, in some cases, which do not subside during the day.

Change body position:

• With ischemic heart disease, the intensity and intensity of pain do not change with physical activity.
• With chest pain, even relatively mild movements cause increased pain or a new onset of pain.

Response to physical activity:

• With ischemic heart disease, the pain appears on exertion, stops at rest.
• In contrast, the angina weakens, but does not stop at rest.

Cupping when taking drugs:

• With an ischemic attack, the pain is easily relieved by taking nitrates.
• Angina pain relieved with the use of pain relievers.

Influence of physiotherapy and manual therapy factors:

• With ischemic heart disease, it is unstable and improves slightly.
• With osteonecrosis, there is a significant positive dynamic in the patient's condition.

Treatment of osteonecrosis in the chest

Osteosarcoma is treated by a neurologist.

In order to organize competent therapy, it is first necessary to establish etiological prerequisites. Determining the cause of the pathology allows you to choose the right treatment regimen.

Preparations for the regeneration of bone tissue are selected taking into account all the functional features of the organism. Preliminary clarification of collagen and elastane levels in the body is recommended. When choosing a treatment regimen, the individual characteristics of the organism are taken into account.

Standard treatment regimen

Nonsteroidal anti-inflammatory drugs help relieve chest pain caused by the inflammatory response. This increases the mobile volume of the ribcage, as well as the range of motion of the thoracic spine.

Drugs that affect the production of interleukin. They allow to stop the inflammatory flow and normalize the balance of enzymes that destroy the myelin sheath of the nerve.

Antispasmodics are also used.

The B vitamins help prevent inflammation of the affected nerves.

Preparations that preserve collagen and elastane levels allow you to keep fluid in the disc. This increases the elasticity of the tissue and prevents further degeneration.

Endocrine drugs (steroids). They have a strong anti-inflammatory effect, but are used only for acute chest pain, since they negatively affect the entire body.

Diuretics in the acute phase of the disease help to reduce swelling at the nerve endings. Preference is given to potassium-sparing diuretics.

Anti-inflammatory ointments and gels. When rubbing on the affected area of the back, local inflammatory processes are reduced and active pain symptoms are eliminated.

Massage

The therapeutic effect of massage is to relieve muscle spasms of the thoracic spine and normalize local blood circulation.

Effects of massage technique:

• eliminate muscle hypertonia;
• strengthens the structure of the organs of the intervertebral disc.

The use of massage techniques is combined with a visit to a chiropractor combined with a regular exercise therapy system.

Physical therapy

Acupuncture. Eliminates or reduces muscle spasms, and also relieves painful symptoms.

Manual therapy. Allows you to return to normal body circulation in the intercostal space. This facilitates the delivery of nutrients to the tissues, improves their nutritional properties and stimulates oxidation in the blood.

Nutrition for osteochondrosis of the thoracic spine

Compliance with certain nutritional principles allows you to achieve the maximum therapeutic effect.

• Foods rich in vitamins A, B, C and E are recommended (green vegetables, nuts, whole grains).
• Omega-3, 6 fatty acids are found in fish.
• Cartilage tissue regeneration stimulant in the form of a food additive allows to maintain the strength of tissues and to maintain the elasticity of tissue structures.

Complications

When confirming the diagnosis of thoracic osteonecrosis, one should take into account the groups of possible organ pathologies that develop over time.

• Cardiovascular system damage: persistent pain syndrome leads to instability in the ion exchange of the myocardium, which is a precondition for the development of coronary artery disease.
• Disorders of functioning of the abdominal organs: stomach, duodenum, pancreas. This is due to the high secretion of adrenaline with persistent pain syndrome, leading to increased secretion of VIP (intestinal peptide).
• Dysfunction of the gallbladder has been shown to be caused by an increase in the jelly-forming capacity of bile against the background of a chronic inflammatory process.

With regular adherence to the principles of treatment, a system of therapeutic exercises, maintaining posture and eliminating risk factors, the course of the disease is reduced to the point of regress. The prognosis is considered favorable if the pathology does not develop further and the disease does not manifest itself actively.

Preventive

• Elimination of hypomobility, therapeutic exercises. Exercises to resist force, load perpendicular to displacement, and stretch the spine are selected.
• When driving a car for a long time, the selection of special exercises to relax the musculature.
• Pumps the muscles of the thoracic spine. There is both a complex exercise therapy and the use of myostimulation during independent exercise is not possible.
• Organization of the workplace: the back of the office chair needs to support the spine. To keep the load on the spine from increasing, you should warm up every 30 minutes with some form of stretching or walking. This is because the sitting position puts more strain on the spine.
• Correcting the position of the spine at night: buy orthopedic sleep accessories. A completely rigid surface is unreasonable due to a violation of the physiological curves of the spine.
• Observe the principles of ergonomics: not lifting weights can cause spinal injury.
• Form the correct posture.
• Optimizing blood circulation and lymph flow through the system of stretch marks or using special procedures (pressure).