Pneumothorax Presentation

Upper Lateral Thoracic Pain
Dx: Pneumothorax (Pulmonary System)
Clinical Presentation: Signs and symptoms vary depending on the size and the location of the pneumothorax.1 Patients may present with severe upper lateral thoracic back pain, ipsilateral shoulder pain, and sudden sharp chest pain or pain over the abdomen.1 Movement and coughing may provoke or aggravate the patients pain.1 The most comfortable position for the patient may be sitting upright and they might also present with dyspnea, a dry hacking cough, change in respiratory movements on affected side, increased neck vein distension, weak and rapid pulse, and/or fall in blood pressure.1 Other common signs and symptoms of a pneumothorax include a decrease or absence in breath sounds,

This article presents a case report about a 31 year old male patient, a teacher at a university, who started experiencing mid back pain after weightlifting one day.3 About 3 hours after weightlifting, the patient began to feel sharp back pain, at levels T4-T8. His pain began to worsen that night causing muscle spasms of his paraspinal muscles, with intermittent radiating pain to his lateral thorax and chest.3 This patient had been diagnosed with thoracic facet injuries in the past, and just assumed it was that.3 However, after the pain did not subside the patient went to his physician who claimed the patient was just having muscle spasms and needed myofascial release.3 However, a radiograph was also done that revealed end plate degenerative changes at T7-T8.3 The patients clinical evaluation revealed muscle spasms of the paraspinal muscles between T3-T12, tenderness to palpate between T6-T8, full shoulder ROM, 5/5 shoulder muscle strength, and normal distal pulses and sensations.3 The patient was diagnosed with thoracic pain and muscle spasms and was give muscle relaxants and exercises for myofascial release.3 Three days after the physician visit, the patient decided to do some walking, to work on his cardio, and experienced mild shortness of