Clinical presentation, quantitative sensory testing, and therapy of 2 patients with fourth thoracic syndrome.

Abstract:

OBJECTIVE:The aim of the study was to describe 2 representative cases of patients presenting to an osteopathic pain practice with signs and symptoms consistent with the fourth thoracic (T4) syndrome. In addition, this article reports the application of quantitative thermosensory testing and dynamometer strength testing to confirm associated sensory and motor strength changes. Nonmanipulative therapeutic interventions are reported for the first time. CLINICAL FEATURES:Two patients experienced paresthesias in all digits of the hands, glove-like numbness of the hands and forearm, weakness (unable to open jars), hand clumsiness, upper extremity coldness, fullness or tightness, deep aching pain, and other signs and symptoms consistent with T4 syndrome. The patients were evaluated using quantitative thermosensory testing and handgrip dynamometry before and after treatment. INTERVENTION AND OUTCOME:Relief of bilateral arm pain, numbness, and paresthesias occurred after intramuscular injections of 1 to 2 mL of 0.5% bupivacaine at the fourth thoracic paraspinal level. Additional therapy for associated signs and symptoms was provided using an anticonvulsant (gabapentin). CONCLUSION:The clinical presentation of the patients reported in this article provides a description and additional information regarding T4 syndrome.

authors

Mellick GA,Mellick LB

doi

10.1016/j.jmpt.2006.04.003

subject

Has Abstract

pub_date

2006-06-01 00:00:00

pages

403-8

issue

5

eissn

0161-4754

issn

1532-6586

pii

S0161-4754(06)00082-0

journal_volume

29

pub_type

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