axillary pain
Introduction
Introduction The axillary region is located between the upper part of the thorax and the upper part of the arm. When the upper extremity is abducted, the crotch area is shallow, called the axillary fossa. Pain in the crotch area is a symptom characterized by various types of pain caused by ankle pain. The pain under the armpit is mostly due to mental stress, long-term posture, local inflammation, breast hyperplasia (mammary gland hyperplasia is the most common breast disease in women, and its incidence is the first in breast disease. The incidence of this disease in recent years is The trend of increasing year by year, the age is getting younger and younger.
Cause
Cause
The cause of pain in the sputum area:
The pain under the armpit is mostly due to mental stress, long-term posture, local inflammation, breast hyperplasia (mammary gland hyperplasia is the most common breast disease in women, and its incidence is the first in breast disease. The incidence of this disease in recent years is The trend of increasing year by year, the age is getting younger and younger. Mammary gland hyperplasia is the physiological hyperplasia and incompleteness of normal breast lobular, the normal structure of the breast is disordered, belonging to pathological hyperplasia, it is a kind of disease that is neither inflammation nor tumor. More common in women aged 30-50, the peak incidence is 35-40 years old.), ischemic heart disease caused by.
Examine
an examination
Related inspection
General radiography examination chest CT examination
The following trials can be used to distinguish between anterior scalene syndrome, clavicle, rib syndrome, and pectoralis minor muscle syndrome:
1. Anterior scalene test: the head turns to the opposite side of the lesion, and it is stretched backwards. The sick side arm is abducted and deeply inhaled. If the above symptoms occur and the iliac artery pulsation disappears, the anterior scalene syndrome is indicated.
2. When the diseased side scapula belt is active or passive downward, the above symptoms and the flank artery pulsation disappear, indicating clavicle and rib syndrome.
3. Both arms are lifted, abducted and slightly to the posterior side. The above symptoms and the sacral artery pulsation disappeared, suggesting a small chest muscle syndrome.
It can be seen in breast hyperplasia, and its symptoms are mainly characterized by periodic pain in the breast. At first, it was a painful pain, and the tenderness was obvious in the upper and middle upper parts of the breast. The pain was exacerbated before menstruation every month, and the pain decreased or disappeared after menstruation. In severe cases, persistent pain was observed before and after menstruation. Sometimes the pain radiates to the ankle, shoulders, upper limbs, and the like. Patients often report a mass in the breast, but only the thickened mammary glands are touched during clinical examination. There are very few puberty simple breast lobular hyperplasia that can heal itself in about 2 years, and most patients need treatment.
It can also be seen in brachial plexus neuritis, which may have a history of immunization or a history of cold. Most of the patients were adults with acute or subacute onset. The initial pain was located on one side of the neck, the supraclavicular fossa or the shoulder. For example, the burning and acupuncture, the pain was intermittent, and soon it became continuous. Paroxysmal intensification. The range of pain extends to the ipsilateral upper arm, forearm, and hand, but to the ulnar side. When the brachial plexus is pulled, the abduction or lifting of the upper extremities often exacerbates the pain. There is obvious tenderness on the brachial plexus (upper, lower, or axillary fossa), which may have a loss of sensation or allergies. Muscle weakness is most severe with the scapula and the proximal muscles of the upper arm.
Costal cartilage inflammation can also feel axillary pain. Generally, 2 to 4 ribs are more common. If the pain is severe, it can be radiated to the armpit, breast and ipsilateral upper limb.
Diagnosis
Differential diagnosis
Identification of symptoms that are easily confused with pain in the sputum area :
(1) The cause of brachialplexus neuritis is unknown. There may be a history of immunization or a history of cold before the illness. Most of the patients were adults with acute or subacute onset. The initial pain was located on one side of the neck, the supraclavicular fossa or the shoulder. For example, the burning and acupuncture, the pain was intermittent, and soon it became continuous. Paroxysmal intensification. The range of pain extends to the ipsilateral upper arm, forearm, and hand, but to the ulnar side. When the brachial plexus is pulled, the abduction or lifting of the upper extremities often exacerbates the pain. There is obvious tenderness on the brachial plexus (upper, lower, or axillary fossa), which may have a loss of sensation or allergies. Muscle weakness is most severe with the scapula and the proximal muscles of the upper arm. At the beginning of the disease, the sputum reflex was more active, but soon it subsided or disappeared. After a few weeks, the muscles have a degree of atrophy. Some patients have autonomic dysfunction at the distal extremity, such as thin skin, swelling, and abnormal sweating. Usually the pain can be alleviated or disappeared within a few days, and some will last for a few weeks. The limbs began to improve in a few weeks or months, but in the end they all improved significantly. Cerebrospinal fluid examination is normal. After the individual patient improved on one side, the other side became ill.
(B) the neck and chest exit area pain syndrome (painsyndrome of thecervicalthaxicoutlet) neck and chest exit area pain syndrome, clavicle, rib syndrome and pectoralis minor muscle syndrome are caused by nerves and blood vessels in the neck and thoracic dorsal exit area. The cervical and thoracic dorsal exit zone is composed of a first rib, an upper sternum in the front, and a first thoracic vertebra in the rear. The brachial plexus passes between the anterior and middle scalene muscles and enters the narrow region between the first rib and the clavicle. The subclavian artery and the brachial plexus are in the same direction, and the neck and the dorsal side of the neck are connected to the neck and enter the upper limb through the armpit. If the above-mentioned pathway undergoes anatomical variation and stenosis, the brachial plexus and blood vessels can be subjected to compression to produce symptoms. Common causes are neck ribs, the seventh cervical vertebrae are too long, the anterior scale muscle hypertrophy or fibroplasia or muscle spasm, contracture, axillary entrance variation, scapular band drop and so on. The onset is mostly 40 to 50 years old, more women than men, and the right side is more than the left side. There are often no obvious incentives and symptoms gradually occur. Initially it was pain and numbness in the upper extremities, radiating from the shoulder area to the inside of the arm and the ulnar side of the palm. Stinging, painful, burning, accompanied by numbness. These symptoms often occur in the early hours of the morning, causing the patient to wake up; or appear after sedentary, long sewing, and other work. Extending the upper limbs, lifting objects, extracts, etc. can aggravate the pain, the arms are adducted, the elbows are flexed, and the symptoms can be alleviated. Physical examination can be found in the hand, forearm ulnar sensation and hyperesthesia. There may be a weakening of the hand muscles and a slight atrophy of the muscles. When the subclavian artery is compressed, the skin of the hand may be chilly, pale skin, bruising, and the like.
