2009-11-07 18:59:36 -
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Each rib is attached to its corresponding member of the thoracic spine. At each level of the spine, a nerve root exits. This nerve supplies not only muscles, but also sensation. It passes under the lower portion of the rib as it progresses around the chest wall.
Inflammation of the nerve occurs in a number of states. This leads to pain
and hypersensitivity along the distribution of the nerve, which largely parallels its rib. At times, x-rays, CT and MRI scans are needed to define the underlying diagnosis.
Causes of Intercostal Neuritis
The most frequent cause of intercostal neuritis is infection with Herpes Zoster. Often, pain will develop over a portion of the chest, followed by the development of a rash in a similar distribution in several days.
Herpes viruses attack the dorsal root ganglion, or region where the sensory nerve body resides just before the nerve passes into the spinal canal.
Other causes of intercostal neuritis include Bornhom's disease or epidemic pleurodynia. Less commonly, intrathoracic or intraspinal tumors may occur. Also, ruptured discs and bone spurs may compress of damage the thoracic nerve roots.
It is necessary to exclude pulmonary and cardiac disease if the diagnosis is uncertain.
Signs and Symptoms of Intercostal Neuritis
Intercostal neuritis produces pain along the distribution of the nerve. This roughly parallels the rib over the affected nerve.
At times, there may be back pain as well.
In cases or Herpes infections, a rash rapidly develops in the distribution of the pain. The rash may break open and become secondarily infected with bacteria.
Cases of spinal tumors and discs may also produce symptoms caused by compression of the spinal cord. These can include leg weakness, incoordination, urinary or fecal incontinence and unstable gait.
Any of these disorders may have their symptoms aggravated with bending and twisting of the chest.
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