Case Study: Deciphering Middle Back Pain

Our Patient

Our patient is a 57 year old male complaining of right posterior thoracic pain that had persisted for over a month. The patient also reported chronic flatulence.

Our Diagnostic Process

Clinical Exam

Our initial clinical exam led us to suspect myofascial pain, with possible nerve compression at the junction of vertebrae T 7-8, and possible respiratory issues.

Diagnostic Ultrasonography

We used high-resolution diagnostic ultrasonography to examine the structures and organs within the thoracic space.

Our diagnostic ultrasound exam revealed:

• An untreated myofascial trigger point at the level of T 6-8, confirming our suspicions of myofascial pain.
• A small lesion in the right thoracic wall.
• Lymphadenopathy (swelling) of the axillary lymph nodes in the retroperitoneal space – the area that includes the adrenal glands, aorta, kidneys, esophagus, ureters, pancreas, rectum, and parts of the stomach and colon.

• A cyst on the left kidney, with impoverished blood vessel architecture in both kidneys – signs of nephropathy (kidney disease).
• Diffuse changes in the liver parenchyma (liver cells).
• Absence of fluid in the pleural cavities and fully pneumatized alveoli, ruling out potential respiratory factors.

Conclusion/Discussion

Musculoskeletal pain is often secondary to lifestyle-induced disorders that disrupt the synchronicity of the body’s systems. Treating myofascial pain without considering other factors is likely to produce unsatisfactory results while overlooking critical health issues.

High resolution diagnostic ultrasonography gives us real-time images of the body’s structures and organs, empowering us to detect potential health problems that contribute to pain and dysfunction. Our holistic approach to patient care goes beyond treating symptoms, to uncovering and addressing issues that pose greater health threats.