Table 1 Variables indicating chest wall syndrome (ambiguous variables in bold)
From: Development and validation of a clinical prediction rule for chest wall syndrome in primary care
Medical history | ||
|---|---|---|
Thoracic pain described as | Sharp/stinging | Trivial |
Aching | Lasting more than 5 min | |
Not squeezing nor oppressive | Localized to one small area of the chest | |
Pressure-like | Left or median left part of the chest wall | |
Of varying intensity | Unilateral | |
Relieving factors | Decrease movement | Nitroglycerine don’t relieve |
Cessation of movement | Rest don’t relieve | |
Change in position | Quiet breathing | |
Physical activity | ||
Associated/triggering factors | Exertion | Physical activities that stress the upper body |
Not exercise-induced | No consistency according to exercise | |
Certain activities | Unaccustomed physical activity | |
At rest | Trunk movement/movement | |
Coughing | Certain position | |
Absence of cough | Antecedent illness with coughing | |
Repeated minor trauma | Deep breathing | |
History of rhumatoid arthritis | Psychic stress | |
Physical examination | ||
Palpation | Pain is reproducible | Chest wall tenderness |
Pain may not be reproducible | Localized muscle tension | |
Paraspinal tenderness | ||
Tests | Horizontal flexion of arm | Spinal motion palpation restriction |