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Pericarditis is distinguished by inflammation of the pericardium, the fibrous sac that encases the heart. It can be acute, lasting less than six weeks, or chronic, persisting for over three months. Understanding its clinical manifestations and diagnostic findings is crucial for timely and effective management.Clinical ManifestationsWhile pericarditis can be asymptomatic, it usually presents with characteristic symptoms such as:Chest Pain: The most characteristic symptom of pericarditis is chest...
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Angina manifests as chest pain, tightness, or squeezing discomfort typically located behind the breastbone. It can radiate to the neck, jaw, shoulders, and inner aspects of the upper arms, most commonly the left arm. Patients may experience shortness of breath, fatigue, profuse sweating, dizziness, indigestion, heartburn, palpitations, anxiety, and vomiting as accompanying symptoms. This pain often lasts a few minutes and is triggered by physical exertion, emotional stress, heavy meals, or cold...
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Sternoclavicular Joint Infection Presenting as Nonspecific Chest Pain.

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Sternoclavicular joint infection (SJI) can present as chest pain, even without typical risk factors. Early diagnosis requires considering advanced imaging like MRI when SJI is suspected.

Keywords:
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Area of Science:

  • Infectious Diseases
  • Orthopedic Surgery
  • Emergency Medicine

Background:

  • Sternoclavicular joint infection (SJI), including septic arthritis (SA), is an uncommon cause of chest pain.
  • Patients often have risk factors, but SJI can occur without them.
  • Standard lab tests and initial imaging may not detect early SJI or osteomyelitis.

Observation:

  • A patient presented with chest, neck, and shoulder pain, initially treated for pneumonia.
  • Symptoms recurred, leading to a diagnosis of left-sided SJI via radiography.
  • The patient had no significant predisposing risk factors for SA.

Findings:

  • SJI can manifest atypically, mimicking other conditions like pneumonia.
  • Delayed diagnosis is common due to non-specific initial symptoms and imaging findings.
  • Magnetic resonance imaging (MRI) is crucial for diagnosing SJI in its acute phase.

Implications:

  • Emergency physicians must maintain a broad differential diagnosis for chest pain.
  • Consider SJI in patients with persistent or recurrent chest/shoulder pain, even without risk factors.
  • Advanced imaging, particularly MRI, should be utilized when SJI is suspected to ensure timely diagnosis and treatment.