Myositis chest Is an inflammation of the skeletal pectoral muscles: groups of superficial and (or) deep pectoral muscles.
Causes of thoracic myositis
Adverse effects of a different nature can lead to inflammation of the pectoral muscles, depending on this, several clinical forms of myositis of the pectoral muscles are distinguished:
Antje muses: Stress-related ptosis. What Eugene says is similar to myasthenia gravis, but what exams do you do? While Eugene takes off his shoes and stockings, lifts his legs and trouser sleeves, Aunt Martha takes the suitcase out of the car. The patellar tendon and the Achilles tendon reflex are as unremarkable as the triceps, biceps, and radial periosteal reflex. Eugene also has no emotional problems. Martha now allows the patient to stand and extend their arms at a 90 ° angle in front of their body.
After about two and a half minutes, they dropped slightly. There is also weakness, ”sighs Eugene. Then he should lie with his back on the sofa and keep his legs and knees at 90 ° to each other. After about a minute, both lower legs sag slightly. Now Martha asks him to watch as long as possible. “This is the Simpson test,” she explains to Antje. "Ptosis occurs in myasthenia gravis with eye symptoms."
Inflammation of muscle tissue can occur both separately and with the involvement of nerve fibers - neuromyositis. In some cases, there is a combination of muscle and skin lesions - dermatomyositis. Multiple muscle lesions are called polymyositis.
Infectious purulent myositis
This form of inflammation is characterized by suppuration of the affected muscle area and is usually caused by a bacterial infection - streptococcal, staphylococcal, pneumococcal, anaerobic. Infection is carried out through an open wound or through blood and lymph from a primary focus located in other organs.
Myasthenic syndrome: also paraneoplastic
“You know that myasthenia gravis suffers from autoantibodies that knock out acetylcholine receptors on the motor endplates,” her aunt explains. If depolarization is followed in rapid succession, less and less acetylcholine is secreted. When myasthenia gravis it can happen that the critical threshold is not reached and no excitation is transmitted -.
"Does he have a normal life span?" Antey wants to know. “Yes,” Martha replies. Assuming he doesn't get myasthenic crisis. - Exacerbation This is a neurological emergency and can end with aspiration and respiratory paralysis is often triggered when patients abruptly stop their medications, infections, or surgery. Many medications can be taken away from. Myasthenia gravis is worse, he will have to take care. “I still don't understand why his tennis player had similar problems,” Antje muses. “These symptoms can also occur with paraneoplasty - most likely in small cell bronchial carcinoma,” her aunt helps. This so-called Lambert-Eaton syndrome can also appear before the tumor can be detected, with auto-antibodies directed against the presynaptic nerve membrane at the motor endplate.
Infectious purulent myositis
This form of myositis of the chest proceeds without suppuration and develops against the background of influenza, respiratory diseases, such chronic diseases as tuberculosis, syphilis, brucellosis. A separate form of infectious thoracic myositis represents Bornholm disease caused by the Coxsackie group virus.
Dystrophy through the X chromosome
The difference is observed with electromyography: with myasthenia gravis, the potential for the sum of action decreases with repeated stimulation of the nerves, but in the case of Lambert-Eaton syndrome, initially too, but this syndrome is rare. Did he have an accident? “No,” Martha shook her head. "Flo has an inherited, rare muscle disease called the Becker-Keener type of muscular dystrophy." "Oh no, does that look like Duchenne muscular dystrophy?" - Antje asks anxiously. “Yes,” the neurologist confirms.
Dystrophin changes or decreases in patients - a protein that is important for membrane function, especially muscle cells - if not, they slowly go away. At school age, paresis and atrophy of the pelvic girdle first develop. As with Duchenne muscular dystrophy, they rise, but thankfully much more slowly. If you hadn't been so in love with your cousin Johann five years ago and paid a little extra attention to Flo, you would have already noticed his fat fat calves - a typical sign.
Autoimmune myositis
This form of myositis is a manifestation of the pathological reaction of the body's immune system to its own tissues. It occurs against the background of certain infections and autoimmune diseases of the connective tissue - collagenoses (vasculitis, systemic lupus erythematosus and others). Most often observed in the form of polymyositis and dermatomyositis.
The atrophied muscle is replaced by fat cells, resulting in pseudohypertrophy. Didn't you notice that his walk looked like he was lying around? And when he squatted, he rested on his hips - the so-called Gowers sign. If we examined him now, he would, at least on the lower limbs, weaken or miss reflexes.
In the immunoblot, colleagues were able to demonstrate the altered molecular weight of dystrophin. This time Antje examines the patient. Sensitivity and reflexes are invisible, as are the eyes. Where her pain is precisely located, Helga may be poor at pointing. “Deep in the muscles of both shoulders,” she says. "It hurts a little, even in the world." In addition to muscle pain, this patient also has skin changes. Redness in the neck and chest indicates dermatomyositis. In the affected muscles, muscle cells invade lymphocytes.
toxic myositis
It is caused by local (insect bite) or general (for example, some medicines) poisoning of the body. With general intoxication, multiple muscle damage is most often recorded.
Ossifying traumatic myositis
Ossifying traumatic myositis is characterized by calcification of the focus of inflammation with the formation of a focus of "ossification" that has arisen against the background of injury - injury, bruise, muscle tear, accompanied by hemorrhage into the thickness of the muscle.
Infectious purulent myositis
Scaly, reddish spots can be seen on the extensor sides of the fingers. Let's go to the hospital, Helga, ”Marta says urgently. "You can take a sample from the muscle to see what you have." Helga thanks and says goodbye. Poor people, Martha sighs. It sounds like dermatomyositis. This is polymyositis. - inflammation of the muscle fibers. - With additional skin lesions in the biopsy, it can be seen that muscle fibers infiltrate lymphocytes more often than polymyositis is dermatomyositis with a malignant tumor associated primarily with it.
Ossifying nontraumatic myositis
This form is also accompanied by the formation of foci of calcification in the muscles and develops without traumatic effects against the background of diseases associated with nerve atrophy, some endocrine diseases, congenital anomalies in the development of connective tissue. Ossifying myositis of a non-traumatic nature usually affects the entire muscular system, as well as the skin, tendons, muscle fascia, and often bones.
Symptoms of myositis nbsp neoplasms
Age, maybe she has a tumor recurrence or metastases. March tried to smile: After this involuntary consultation, you know at least the characteristic symptoms of myopathy - often slowly - decreasing forces, often from proximal muscles without sensory disturbances, spastic symptoms or bundles, as in nervous disorders, are usually absent. “You will really learn something with you,” says Antje. "What topic are we going to discuss at the next wedding, maybe epilepsy?" Oh no, the doctor laughs. "Let's hope it won't be needed!"
Professional myositis
Professional myositis of the chest is a type of traumatic. The reason for the development is muscle overstrain caused by repeated monotonous movements or prolonged stay in one position.
Risk factors
The factors that provoke the development of chest myositis include:
Cervical type of disease
During a physical exam, the doctor checks the breasts for areas of tenderness or swelling. The doctor may also move the chest or arms in a specific way to try to trigger symptoms. Stochondrosis pain can be very similar to pain associated with heart disease, lung disease, gastrointestinal problems, and osteoarthritis. Although a laboratory or image test does not confirm the diagnosis of stochondrosis, a doctor may order certain tests, such as an electrocardiogram, X-ray, computed tomography, or MRI, to rule out other conditions.
One of the main impulses for the development of myositis is hypothermia. It weakens the immune system, increases the likelihood of respiratory infections, and increases the risk of other factors.
Symptoms
External manifestations of myositis of the chest:
In case of damage to the superficial pectoral muscles, pain and limitation of mobility are observed when moving the arms, abducting the shoulder blades, and turning the torso.
Costochondritis usually goes away on its own, although it can last for several weeks or more. Treatment focuses on pain relief. A doctor may recommend. Although some medicines, such as ibuprofen or naproxen sodium, are available over the counter, your doctor may prescribe stronger versions of these nonsteroidal anti-inflammatory drugs. Tricyclic antidepressants such as amitriptyline are often used to control chronic pain. Anticonvulsants. The drug for gabapentin epilepsy has also been shown to be successful in chronic pain.
- Non-steroidal anti-inflammatory drugs.
- Tranquilizers can be addictive.
- Antidepressants.
If the deep pectoral muscles are affected, the leading symptom is pain accompanying breathing.
Infectious and autoimmune myositis may be accompanied by high temperature, chills, headache, weakness, general ill health.
Dermatomyositis is accompanied by red or purple rashes in the area of \u200b\u200bthe shoulder blades, chest, neck, face. The rash can also accompany myositis of an autoimmune nature.
Surgery and other procedures
Stretching Exercises Gentle chest stretching exercises can be helpful. Nerve stimulation In a procedure called transcutaneous electrical nerve stimulation, the device sends a weak electrical current through adhesive patches on the skin near the area of \u200b\u200bpain. The current can interrupt or mask pain signals, preventing them from reaching the brain. If conservative measures don't work, your doctor may suggest that you inject an anesthetic and a corticosteroid directly into the joint in pain.
Lifestyle and home remedies
It can be frustrating to know that there is little a doctor can do to treat stochondrosis. But personal hygiene measures can make you feel more comfortable. Try putting warm compresses or heat packs on an area that hurts several times a day. Ice can also be helpful. Avoid activities that make pain worse.
- Non-steroidal anti-inflammatory analgesics are available without a prescription.
- Ask your doctor about using ibuprofen or naproxen sodium.
- Warm or cold.
- Keep the heat setting at a low intensity.
Muscle inflammation can occur in acute, subacute and chronic forms. Acute myositis is characterized by violent manifestation of symptoms (acute pain, fever, severe limitation of mobility). Then, within one to one and a half months (more often - earlier), recovery occurs or the disease becomes chronic, when the symptoms are much weaker. For chronic forms, periodic exacerbations are characteristic. In subacute forms, symptoms are less pronounced than in acute ones.
Questions to ask your doctor
Consider your symptoms, even those that may seem unrelated to the reason for which you scheduled the consultation. Write down your most important medical information, including other illnesses and any history of joint injuries that are causing you pain. Write down your most important personal information, including what is causing the most stress or recent changes in your life. Ask a family member or friend to accompany you to help you remember what the doctor is telling you. Write questions to ask your doctor. How long do you expect the symptoms to disappear? I have other health problems. What is the best way to control them together?
- List all of your medicines, vitamins, and supplements.
- What is the most likely cause of my symptoms?
- What tests do I need to do?
- What personal care measures are likely to help me improve my symptoms?
- Should any activity be restricted?
- What symptoms and symptoms should be observed at home?
Traumatic ossifying myositis can proceed imperceptibly - the disease is often detected only when a solid node is felt in the thickness of the muscle.
Treatment
For the treatment of myositis, conservative (non-surgical) methods are mainly used; surgical operations are rarely resorted to. The affected muscles must be provided with rest and warmth.
Traditional methods of treatment
The doctor will probably ask you a series of questions. By being ready to answer them, you can leave time to review the points you want to spend more time on. Can you ask the following. Are you having trouble breathing? You recently had respiratory infection? Have you had an early chest injury? Have you been diagnosed with any other medical conditions? Have you experienced a lot of stress or significant changes lately? Do you know if you have a family history of heart problems? In: Fundamentals of Physical Medicine and Rehabilitation: Musculoskeletal Disorders, Pain and Rehabilitation. ª ed. What are the most common reasons chest pain? Outpatient diagnosis of acute chest pain in adults.
- When did you first get these symptoms?
- Have they gotten worse over time?
- Where is your pain?
- Does physical or physical manifestation exacerbate symptoms?
- Is there something that makes the pain better or worse?
- Thoracic pain.
- Bone Syndrome.
Drug treatment
Antibiotics and sulfa drugs are used to treat infectious myositis.
Autoimmune myositis is treated with corticosteroids and antimetabolites.
Intravenous administration is used to treat toxic myositis saline solutions, ingestion of enterosorbents, vitamin therapy.
Pain and inflammation are relieved by non-steroidal anti-inflammatory drugs in the form of ointments, tablets, injections, as well as local irritants (plasters, ointments, compresses).
Physiotherapy
Physiotherapy can relieve pain and cope with the inflammatory process. The following methods are used in the treatment of myositis:
- infrared and ultraviolet radiation;
- magnetotherapy;
- myostimulation;
- phonophoresis of hydrocortisone;
- electrophoresis;
- diathermy;
- UHF therapy
- ozokerite applications;
- massage;
- physiotherapy exercises.
Physiotherapy is applied after the exacerbation stage has passed.
Surgery
Surgical treatment is indicated for purulent myositis: the focus of suppuration is opened, cleaned and drainage is installed.
With ossifying traumatic myositis, a surgical operation - removal of the ossification (calcified muscle area) - is prescribed in the following cases:
- if the ossification is close to the joint and limits its mobility;
- with the threat of injury from ossification of a large blood vessel;
- with irritation and compression of the nerve trunk.
If myositis is a manifestation of some common disease - infectious, immune, then first of all this disease is treated.
If you find probable signs of myositis of the chest, you should immediately consult a doctor. Myositis can only be diagnosed by a doctor, since the symptoms accompanying muscle inflammation can also be observed in other diseases, for example, osteochondrosis of the cervical and thoracic, tumors (including malignant), diseases of the heart, lungs, pleura. In such cases, pain and compaction in the muscles have nothing to do with their inflammation and are treated differently. Self-medication can not only cause complications (for example, with purulent myositis), but also lead to the fact that formidable pathologies that have nothing to do with myositis will not be recognized in time.
To clarify the diagnosis, the doctor may need X-ray, puncture (puncture of the affected area), biopsy (taking a sample for histological examination), laboratory blood tests. Only after an accurate diagnosis has been established, the doctor will be able to prescribe an effective treatment.
Myositis is a disease associated with inflammation of the skeletal muscles and disruption of its normal functioning. Thoracic myositis is a disease of the muscles of the thoracic trunk, manifested by weakness, aching pains along the anterior wall of the sternum. In the case of intercostal myositis, the intercostal muscles are affected.
The inflammatory process can affect one or more muscles. If several muscle groups are inflamed at once, then polymyositis takes place. In addition to muscle tissue, pathology can spread to the skin, causing the development of dermatomyositis.
In the acute phase of development, myositis of the intercostal muscles is manifested by an increase in pain syndrome, especially with sudden movements or palpation of the inflamed area. Pain can radiate to the shoulder girdle, neck and upper limbs.
Important: Chest myositis is more often characterized by a chronic course and over time can lead to the death of the chest muscles.
Causes of intercostal myositis
Intercostal myositis, the symptoms of which are mainly due to the muscle-fascial syndrome, can be caused by the following factors:
Important: The occurrence of thoracic myositis is most susceptible to people whose work activity is accompanied by heavy loads or prolonged stay in an anatomically incorrect posture. The risk group is made up of drivers, office workers, violinists, pianists.
Clinical signs of intercostal myositis
Myositis of the chest muscles is characterized by extensive symptoms and a varied course of the disease. Intercostal myositis has the following characteristic symptoms:
- swelling and swelling of tissues forms at the site of inflammation;
- there is an increase in temperature, hyperemia and soreness of the skin in the area of \u200b\u200binflammation;
- pain in the intercostal space is dull, paroxysmal, aggravated by pressure or a change in the position of the body;
- the intercostal muscles are very tense, on palpation, seals can be felt;
- breathing processes are difficult, shortness of breath and cough, headache appear.
The main clinical sign of myositis is muscle pain of a certain localization, due to the location of the inflamed muscles. Pectoral myositis is manifested by pain in the pectoralis major muscle.
Important: Intercostal myositis is easily confused with intercostal neuralgia. They are differentiated by the nature of pain on palpation. In the first case, pain is felt along the entire intercostal space. Neuralgia is characterized by the presence of three pain points in the spine, sternum and lateral chest.
Thoracic myositis, the symptoms of which are severe painful sensations, due to muscle tension and compression of the articular and cartilaginous joints, leads to limited mobility. Myositis of the chest on the left may resemble signs of heart disease. In this case, it is necessary to exclude the presence of pathology of the cardiovascular system.
Methods for the treatment of chest myositis
For the treatment of inflammation of the muscles, physiotherapy, massage, balanced nutrition, and physical therapy are shown. First of all, the reasons that caused the chest myositis are established. Treatment inflammatory process in muscle fibers is specific and strictly individual. In any case, myositis of the chest, the symptoms of which are manifested by a feeling of pain, is associated with the use of anti-inflammatory, analgesic and antipyretic drugs.
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Local muscle pain is effectively eliminated by warming ointments. They improve muscle nutrition, thereby reducing muscle tension. When acute inflammation muscles, bed rest is recommended. Woolen headbands can be used.
Do not delay the treatment of chest myositis. The disease can progress rapidly, spreading to other groups of muscle fibers. Based on the severity of the disease, as well as the characteristics of the patient's body, the doctor will determine the optimal list of therapeutic measures.