Myositis of the chest is a condition that is accompanied by the development of inflammation in the skeletal muscles of the chest. This type of disease is characterized by: significant pain, limiting movement, the formation of seals on the muscle, the development of atrophy in the affected area.
According to the ICD, myositis of the chest is assigned the code M60.
Clinical manifestations
Thoracic myositis, unlike other forms of trunk myofasciculitis, has specific features:
- Soreness occurs gradually, developing from limited points of inflammation and spreading throughout the body.
- When probing, formations of a spherical shape are clearly detected - inflammatory foci in which the muscle tissue is reorganized into solid dense nodules.
- Pain syndrome with myositis of the thoracic region is continuous, it is also characterized by diversity - aching pains are quickly replaced by acute pains. Pathology makes movement much more difficult.
- Atrophicphenomena in the muscular tissue increase under the influence of catarrhal phenomena.
- The following symptoms of chest myositis are also characteristic: the occurrence of spasms, decreased performance, general malaise, hyperthermia, shortness of breath, cough, migraine attacks, dizziness.
Causes of occurrence
Specialists identify several factors contributing to the development of chest myositis:
- Viral diseases, acute tonsillitis, tuberculosis, connective tissue pathologies (scleroderma, SLE, vasculitis, collagenosis), autoimmune diseases, joint diseases (osteochondrosis, rheumatoid arthritis).
- Intoxication of the body with industrial waste (pesticides, chemicals).
- Parasitic infections (bovine tapeworm, pork tapeworm, trichinella, echinococcus), intoxication with waste products of parasitic organisms.
- Hypocooling due to exposure to air conditioners in hot weather, drafts. The development of myofasciculitis is facilitated by a sharp hypothermia of heated muscles.
- Traumatic influence - sprains, fractures, muscle tear, injury, bruises. Sports injuries associated with one-time excessive loads, weightlifting, weight lifting.
- Professional harm arising from activities associated with a constant stay in a stationary position and overexertion as a result of constantly repetitive monotonous movements.
- Infection with anaerobic, pneumococcal, staphylococcal,streptococcal infection. It often develops in violation of the rules of asepsis, sterility of premises, infection of a wound infection during medical procedures.
- Nerve damage caused by pathologies of the endocrine system (hormonal disruption, diabetes, hyperthyroidism), pregnancy.
- Medical manipulations, the side effect of which may be myofasciculitis (dental procedures on carious teeth, the use of drugs based on snake venoms, vincristine).
Symptomatics
Myositis of the chest (ICD-10 M60) is manifested by the following symptoms:
- Externally manifested as the development of puffiness, swelling in the projection of the focus of inflammation, focal hardening, softening of muscle tissue. Palpation of the affected area reveals tension, nodular formations of a dense structure, changes in consistency, tuberosity. Symptoms of chest muscle myositis should not go unnoticed.
- A severe pain syndrome develops. The pain may be aching, stabbing, shooting in nature. It occurs with movements of the shoulder blades, raising the arms, movements of the torso, deep inhalations and exhalations. Irradiation to the arms, shoulders, neck, dorsal region is not ruled out. Against the background of myositis, cerebroalgia (intense pain in the head) can also develop.
- Catarrhal syndrome, which consists in general weakness, high temperature, hemorrhagic rashes.
- In the morning and in the evening myositis of the chest muscles on the left or on the right can manifest itselfnumbness, tingling.
- Redness, hyperthermia of the skin of the chest.
- It is not excluded the accession of damage to nearby organs - inflammation of the laryngeal muscles, cardialgia, shortness of breath, cough.
Diagnosis of myositis
The initial diagnosis of chest myositis is to conduct an external examination, history taking, palpation.
If diagnosis by clinical signs and palpation is difficult, laboratory testing of blood samples for the presence of eosinophils, specific antibodies, indicators of inflammation, enzyme activity is recommended. In addition, ultrasound examination of muscles, electromyography, X-ray examination, MRI, CT are shown. With advanced myositis, it is recommended to conduct a histological examination of a sample of the affected muscle taken by biopsy.
Differential Diagnosis
Differential diagnosis allows you to determine the type of muscle damage and determine the treatment regimen. Myofasciculitis is distinguished from angina pectoris, chondrosis, lung diseases, pleura.
Classification
One common type of muscular lesion that leads to atrophy is inflammation in the intercostal muscles. Pathology is characterized by the appearance of soreness in the evening and at night (after overwork, stress), swelling of the skin, stiffness of movements. In some cases, purulent inflammatory foci come to the surface. The patient suffers from pain in the hypochondrium, which canhave a paroxysmal character and intensify with pressure, a change in body position. There is also tension in the intercostal muscles, breathing becomes difficult.
Left and right localization
Myositis can have left-sided and right-sided localization. According to the type of course, myositis is classified into acute and chronic.
Inflammation of the large muscle of the chest, most often occurs on the one hand, is accompanied by pain and resembles cardiac pathologies. It is not excluded the occurrence of numbness of the hands, pain in the neck from the source of inflammation, prone to spontaneous disappearance.
Treatment of chest myositis
Therapy for intercostal myositis should be carried out comprehensively and selected for each patient individually. The general principles of treatment are complete rest and bed rest, proper nutrition, enrichment of the diet with microelements, vitamins, exclusion of smoked meats, spicy dishes, and alcohol. It is also important to consume a large volume of mineral water enriched with alkaline elements.
Drug therapy for myositis involves the use of the following drugs:
- Antibiotics, sulfonamides ("Azithromycin", "Ampicillin", "Amoxiclav", "Erythromycin"). These medicines allow you to influence the trigger of the pathology.
- Non-steroidal anti-inflammatory drugs that can eliminate catarrhal manifestations, swelling, soreness. Most often, the patient is recommended injection forms, dragees, patches, ointments "Voltarena", "Diclofenac",Ibuprofen, Ketofen.
- Steroid drugs ("Prednisolone", "Methylprednisolone", "Hydrocortisone"), immunosuppressors, if the pathological process is characterized by massiveness, and there is no effect from the use of NSAIDs.
- In myositis of parasitic etiology, the use of desensitizing agents, anthelmintic drugs ("Nemozol", "Vermox") is indicated.
Physiotherapy
Along with drug therapy for chest myositis (ICD code M60), physiotherapy methods are actively used: hirudotherapy, apitherapy, reflexology, balneotherapy, electrophoresis, diathermy, phonophoresis using hydrocortisone, magnetotherapy, tissue neurostimulation, laser therapy, myostimulation, heating, applications ozokerite, paraffin.
Physiotherapy methods can only be used in the absence of an exacerbation.
Effectively eliminate congestion, relieve spasm, improve microcirculation allows massage. In combination with physiotherapy exercises, it is possible to completely restore the affected areas.
Surgery
In extremely rare cases, surgery may be indicated. The operation is performed if the myositis has an ossifying form and the removal of bone ossification is required. In such cases, conservative therapy is powerless. Also, surgical intervention is indicated for purulent myositis, when opening of the pyogenic capsule and elimination is required.bacterial content.
In combination with traditional therapy, the use of alternative methods of therapy is allowed:
- Compresses based on alcohol, herbs, vegetables.
- Warming liniments based on cinquefoil.
- Homemade decoctions, tinctures based on St. John's wort, willow bark.
Probable Complications
When carrying out untimely diagnosis and correction of myofasciculitis, there is a possibility of chronic inflammation, the addition of various complications. The most common complications of intercostal myositis are:
- Restriction of motor function with the transition to complete immobilization. In severe cases, the disease can become irreversible and lead to disability.
- Defeat of the plexus of nerves in the thoracic part of the torso, the occurrence of numbness of the limbs, up to paresis of the hands.
- Occurrence of an unpleasant crunch, clicking in the affected area. It develops as a result of the transition of the process of inflammation to cartilage.
- Development of uncomfortable and unpleasant sensations during and after exercise.
- Swelling, inflammation of the joints.
- Muscle atrophy resulting in weakened support for the spinal column. Such a complication is fraught with the occurrence of spinal deformities - scoliosis, pathological kyphosis, lordosis, fan-shaped displacements of the vertebrae.
- Prolonged inflammation can provoke the attachment of the bacterial component through the wound surfaces. As a result, a purulent inflammation occurs, accompanied bymelting of surrounding tissues, formation of fistulas, contamination of adjacent organs with bacterial contents.
To prevent unwanted life-threatening complications, it is important to see a doctor and diagnose the disease in a timely manner.
We looked at the symptoms and treatment of chest myositis.
