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Chiropractic Research Review

Clinical Assessment of the Thoracic Region

The thoracic spine and the thorax are of frequent clinical relevance and the subject of many patient complaints. Thoracic pain or discomfort commonly originates in mechanical structures of the cervical, thoracic and lumbar spine, or the rib cage and shoulder girdle, although numerous other chest and abdominal conditions may also refer symptoms to the region.

This comprehensive article reviews some of the basic elements necessary for appropriate evaluation of the thoracic complex.

Biomechanical and visceral contributions to thoracic pain are presented and a practical review of patient evaluation strategies is undertaken, including a discussion of:

* history;
* differentiating mechanical vs. visceral pain;
* motion, muscle and joint analysis;
* orthopedic and neurologic testing; and
* patient charting techniques.

Particular attention is paid to ruling out potential serious underlying visceral causes of thoracic pain, such as pulmonary and cardiovascular complications, infections or tumors. The authors emphasize that assessment of the thoracic region should be performed "within the context of the overall patient assessment."

Mootz RD, Talmage DM. Clinical assessment strategies for the thoracic area. Topics in Clinical Chiropractic, Sept. 1999:6(3), pp1-19. Reprints: (800) 638-8437

Chiropractic Research Review

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