Xiphodynia: Definition, Description, Causes and Risk Factors
Symptoms:Xiphodynia is a musculoskeletal disorder capable of producing a constellation of symptoms that mimic several common abdominal and thoracic diseases including:
- Cardiac chest pain.
- Epigastric pain.
- Nausea, vomiting and diarrhea.
- Radiating pain into the back, neck, shoulders, arms and chest wall.
Diagnosis:The diagnosis of xiphodynia is dependent upon the reproduction of the patient's symptoms completely or in part by moderate pressure on the xiphoid process and its adjacent structures. Even though xiphodynia often exists in the absence of any other medical condition, it has been demonstrated in conjunction with life-threatening disease such as cardiac disease including angina pectoris, myocardial infarction, and pericarditis. It is therefore imperative that any patient presenting to a primary health care provider with acute chest or abdominal pain be carefully investigated to establish a diagnosis and treatment plan where appropriate, emergency medical care must be rendered. In cases where a clear medical diagnosis cannot be established, a simple provocative test may uncover a symptomatic xiphoid process and establish the diagnosis of xiphodynia. In those patients who receive treatment for an established 'medical condition' in whom symptoms persist, consideration might be given to examining for xiphodynia.
Xiphodynia Treatment:The literature suggests that xiphodynia is a self-limiting disorder to be treated with reassurance or with analgesics, topical heat and cold, and an elastic rib belt. It is clear from these and other reported cases that xiphodynia may not be self-limiting. The medical 'treatment of choice' is an injection of local anaesthetic and steroid. Xiphoid injection, while often curative, is not without risk of complications including pleural or peritoneal perforation, pneumothorax, or infection. Conservative physical therapies are worth a trial, however no evidence exists for their effectiveness with xiphodynia. NOTE: The above information is educational purpose. The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. DISCLAIMER: This information should not substitute for seeking responsible, professional medical care.
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