-IBIS-1.5.0-
tx
nervous system
intercostal neuralgia
diagnoses

definition and etiology

definition:
Pain in the nerve that runs between two ribs (intercostal nerve).

etiology:
The etiology is frequently unknown. Trauma can initiate nerve irritation, as well as a Vitamin B1 deficiency.

signs and symptoms

signs and symptoms:
• Pain: can begin suddenly: lancinating, sharp, stabbing. It follows along the course of the ribs. The pain can be worse movement of the torso, breathing, and exposure to the cold.
• Diagnosis can be made by eliciting tenderness of the nerve path with palpation, while ruling out more serious pathology. Tenderness is generally worse by the axilla, near the vertebral foramen, and by the parasternal line.
• (-) signs indicating pulmonary or pleuritic infection.
• (-) signs indicating vertebral fixation or muscular strain/sprain.
• History high stress, poor food choices (possibly indicating Vitamin B deficiency).

lab findings:
• (-) tests for infectious state (e.g. CBC).
• (-) x-ray.

course and prognosis

While painful, intercostal neuralgia is not serious. It typically is self-limiting but may last for quite a while, causing mild to severe discomfort.

differential diagnosis

• Pulmonary infection.
• Pulmonary embolism.
• Pleurisy.
• Costochondritis.
• Rib fracture: acute or poorly healed.
• Diaphragmatic spasming with exercise.
• Muscle strain/sprain (especially pectoralis muscles).
• Rib periostitis.
• Intercostal muscle spasm: periodic episodes of sharp pain in the chest wall, < deep breathing and > shallow breathing; may be relieved by very deep, slow breath through the pain.


footnotes