Sternocleidomastoid muscle attachment tenderness
Introduction
Introduction The sternocleidomastoid tendonitis is more common in clinical practice, mostly caused by cold and cold invasion, and it is aseptic inflammation and strain of tendon. The tenderness at the attachment of the sternocleidomastoid is clearly one of its diagnoses.
Cause
Cause
The cause of tenderness in the attachment of sternocleidomastoid
Strain damage causes chronic damage to the tendon, poor sleep posture, can increase the traction damage of the sternocleidomastoid muscle. If the neck is not warm, the blood supply of the tendon will be further reduced, and the necrotic cells and exudate of the damaged tendon will be damaged. Can not be ruled out, form edema, stimulate nerve endings, and cause a series of clinical manifestations.
Examine
an examination
Related inspection
Anterior serratus muscle strength test chest radiograph
1. No history of obvious trauma, but there is a history of straining that often rotates the head and raises the head or suddenly over-rotates the head.
2. The neck rotation activity is limited and the neck is stiff.
3. Passively do head rotation or neck overextension. Causes sternocleidomastoid muscle tendon pain and sternocleidomastoid tendon.
4. The tenderness is obvious at the attachment of the sternocleidomastoid muscle.
Diagnosis
Differential diagnosis
First, the diagnosis points
1. No history of obvious trauma, but there is a history of straining that often rotates the head and raises the head or suddenly over-rotates the head.
2. The neck rotation activity is limited and the neck is stiff.
3. Passively do head rotation or neck overextension. Causes sternocleidomastoid muscle tendon pain and sternocleidomastoid tendon.
4. The tenderness is obvious at the attachment of the sternocleidomastoid muscle.
Features:
The place of pain is only concentrated, and the patient can clearly point it out.
The pain is not long, and usually only lasts for one or two seconds, and there is a chance to relapse.
When the patient takes a deep breath, coughs, sneezes or turns around, the chest is stinging and even painful.
Pain may be more intense than chest pain caused by other diseases, but most of them improve within a few days to two or three weeks.
Second, the tenderness of the sternocleidomastoid attachment site requires differential diagnosis of symptoms:1, pectoralis major muscle pain: generally for the pectoralis major muscle attachment sterile inflammatory lesions, pectoralis major muscle strain, spinal soft tissue damage.
2, lower sternal tenderness: tenderness of the lower sternum is one of the important signs of leukemia. In addition, it can also be seen in malignant lymphoma and myeloproliferative diseases, but the latter two are relatively rare. Leukemia, also known as blood cancer, is one of the most important signs when people suffer from leukemia, especially acute leukemia. According to clinical observations, the most obvious site of sternal tenderness in most patients is in the lower part of the sternum, which is equivalent to the sternum of the fourth and fifth intercostal spaces. Medical scientists believe that the cause of bone pain is mainly caused by the proliferation of leukemia cells in the bone marrow, the increase of the volume pressure of the bone marrow cavity, and the infiltration of the periosteum by the leukemia cells to stimulate the sensory nerve. From an anatomical point of view, the sternum plate is very thin, the skin covering this part is also very thin, and the periosteal sensory nerve is also rich, so it is sensitive to the touch pressure, and tends to produce obvious tenderness.
3, sternal tenderness: the most obvious part of the sternal tenderness in most patients in the lower part of the sternum, which is equivalent to the sternum of the fourth and fifth intercostal space.
4, chest pain: chest pain is a common symptom in the emergency department, usually caused by chest disease, the severity of chest pain does not necessarily have a definite relationship with the cause of chest pain, such as chest herpes zoster can produce severe chest pain, and acute myocardial infarction Chest pain is sometimes not very serious.
5, chest wall pain: chest wall pain (chestwallpain) also known as musculoskeletal pain (musculoskeletalpain).
