Musculoskeletal chest wall pain

January 01, 0001

Musculoskeletal chest wall pain

Chest wall syndrome (CWS) is a common etiology of chest pain in primary care settings. These German and Austrian researchers endeavored to describe the epidemiology, clinical characteristics and prognosis of CWS. Patients 35 years of age and older who presented with chest pain to primary care clinics were enrolled (n=1212). An independent interdisciplinary reference panel reviewed clinical data of every patient and decided determined the cause of the chest pain. Multivariable regression analysis was performed to identify clinical predictors.

The authors found: "GPs diagnosed pain originating from the chest wall in 46.6% of all patients. In most patients, pain was localized retrosternal (52.0%) and/or on the left side (69.2%). In total, 28.0% of CWS patients showed persistent pain and most patients reported no temporal association of pain (72.3%). In total, 55.4% of patients still had chest pain after 6 months. A simple score containing four determinants (localized muscle tension, stinging pain, pain reproducible by palpation and absence of cough) shows an area under the receiver operating characteristic curve of 0.78."

The authors concluded: "This study broadens the knowledge about pain characteristics and the diagnostic accuracy of selected signs and symptoms for CWS. A simple four-point score can help the GP in the diagnostic workup of chest pain patients."

This study sheds light on characteristics that distinguish musculoskeletal chest wall pain from other etilogies of chest pain.

For the full abstract, click here.

Family Practice 27(4):363-369, August 2010 © 2010 the Author
Chest wall syndrome in primary care patients with chest pain: presentation, associated features and diagnosis. Stefan Bösner, Annette Becker, Maren Abu Hani, et al.. Correspondence to Stefan Bösner: [email protected]

Category: M. Musculoskeletal. Keywords: chest pain, chest wall, diagnosis, prevalence, primary health care, epidemiologic study, journal watch.
Synopsis edited by Dr Paul Schaefer, Toledo, Ohio. Posted on Global Family Doctor 6 August 2010

Pearls are an independent product of the Cochrane primary care group and are meant for educational use and not to guide clinical care.

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