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25 - Clinical examination of the thoracic spine

Copyright 2013 Elsevier, Ltd. All rights Clinical examination of the thoracic spineCHAPTER CONTENTSI ntroduction ..365 Principal differences between the thoracic and the lumbar and cervical spines .. 365 Referred .pain ..366 Pain referred from musculoskeletal structures .. 366 Pain referred from visceral structures.. 369 History ..370 Pain .. 370 Paraesthesia .. 372 Anticoagulant treatment and bleeding disorders.. 372 Inspection .and .palpation ..372 Scoliosis .. 372 Kyphosis .. 372 Functional . examination ..372 Standing .. 373 Sitting .. 374 Lying prone .. 376 Accessory .tests ..376 Technical .investigations ..381 IntroductionThoracic or abdominal wall pain is a common complaint and poses a major diagnostic challenge to physician and pain is often referred from visceral disorders, although the frequency of musculoskeletal lesions of the thorax and the abdomen should not be underestimated.

Clinical examination of the thoracic spine. C H A P T E R 2 5 367. Cervical discoradicular interactions A posterolateral disc protrusion compressing the C5, C6, C7 . or C8 nerve root gives rise to unilateral root pain characterized mainly by a …

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vicular joint, which is of C4 origin (Fig. 12.1). In acromiocla-vicular joint problems the pain is felt at the tip of the shoulder, with little spread. Exceptionally, when the lesion lies at the inferior acromioclavicular ligament, the pain can spread into the upper arm. In a lesion of one of the other shoulder structures, such as

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carpal joint) which has its concave surface at the radial side. The joint moves along two axes: anteroposterior for ulnar and radial deviation, and transverse for flexion and extension (Fig. 4). Distally, the intercarpal joint is between the proximal and . distal rows of bones (Fig. 5), is an open S-shape and acts as a hinge.

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