Body Aches

Body aches can an entire limb or part concern (for joint pain and joints). The pain can be constant or intermittent and are not related to movement or triggered by them. The accompanying symptoms and complaints often suggest a cause. Etiology Muskoskeletäre injuries and overuse are the most common causes of pain in a limb, but are easily recognizable by the history. This discussion deals with extra-articular body aches that are unrelated to injury or stress. Pain, which are only present in a joint or in multiple joints, are discussed elsewhere. There are many causes (see Table: Some causes of non-traumatic limb pain), but the most common are the following: Deep vein thrombosis (DVT) cellulitis radiculopathy unusual but serious causes that require immediate diagnosis and treatment include acute arterial occlusion deep soft tissue infection Acute coronary ischemia (manifested only referred arm pain) Some causes of non-traumatic limb pain cause Suggestive findings Diagnostic approach Muskoskeletär and soft tissue Cellulite Focal redness, warmth, tenderness, swelling Sometimes fever Clinical evaluation Sometimes blood and tissue cultures (eg. As when patients are immunocompromised) deep soft tissue infection (eg. As myonecrosis, necrotizing subcutaneous infection) depth, constant pain, typically disproportionate with the findings redness, warmth, tenderness, tense swelling, fever Sometimes crepitus, lazy discharge, blisters or necrotic areas , signs of systemic toxicity (eg. as delirium, tachycardia, pallor, shock) blood and tissue cultures radiograph Sometimes MRI osteomyelitis depth constant, often nocturnal pain tenderness of the bones, fever often risk factors (eg. as immune deficiency, parenteral drug use, known contiguous or remote infec tion source) X-ray, MRI and / or CT Sometimes cultured bone bone tumor (primary or metastatic) deep, constant, often nocturnal pain tenderness of the bones is often a known cancer X-ray, MRI and / or CT Vascular Deep vein thrombosis swelling, often warmth and / or redness, sometimes venous distension Often risk factors (eg. B. hypercoagulable, operation and recent or immobility, cancer) ultrasonography may D-dimer Test Chronic venous stasis Slight discomfort associated with swelling, redness and warmth of the distal lower extremity Sometimes shallow ulcers Clinical evaluation Acute ischemia (usually by arterial embolism, section or thrombosis, but sometimes by massive iliofemoral vein thrombosis, which completely obstructs flow in the limb) sudden, severe pain signs of distal limb (z. B. Cool, pallor, pulse deficits, delayed capillary refill) sometimes chronic ischemic lesions (e.g.. B. atrophy, hair loss, pale color, ulceration) After several hours, neurological deficits and tenderness of the muscles Sometimes known peripheral vascular Immediate arteriography Peripheral arterial insufficiency Intermittent leg pain predictably triggered by exertion and relieved by rest (intermittent claudication), sometimes pain at rest, which can be reinforced with lifting the legs Low ankle-brachial blood pressure index, chronic ischemic skin lesions ultrasonography Sometimes arteriography Neurologically plexopathy (Brachial or lumbar) pain; usually weakness, loss of reflexes Sometimes numbness in a nerve plexus distribution usually electrodiagnostic tests (electromyography and nerve conduction velocity) Sometimes MRI Thoracic Outlet Syndrome pain and paresthesias starting unclear in the neck or shoulders to medial areas of the arm and hand, but may electrodiagnostic tests and / or MRT radiculopathy (z. B. caused by disc herniation or osteophytes) pain and sometimes sensory deficits after a dermatomal distribution and often degradation in motion often neck or back pain usually Sch wäche and decreased deep tendon reflexes in a nerve root distribution Typically MRT painful polyneuropathy (eg. B. alcoholic neuropathy) Chronic, burning pain, typically (in both hands or both feet Sometimes sensory abnormalities such as hypoesthesia, hyperesthesia and / or allodynia (pain in non-painful stimuli) Clinical Evaluation Complex regional pain syndrome complex regional pain syndrome, CRPS) Burning pain, hyperesthesia, allodynia, vasomotor abnormalities Typically, a previous injury (which may be far away) Clinical evaluation Other Acute (caused coronary ischemia circumscribed arm pain s) the absence of explanatory physical findings at the site of pain; other findings suggestive (z. B. history that is indicative of coronary artery disease, sweating and / or dyspnea that occur simultaneously with arm pain) ECG and troponin i. S. Sometimes stress tests or coronary angiography myofascial pain syndrome Chronic pain and tenderness along a muscle tensed belt deterioration in movement and pressure on a triggering point (focal region separated from the location of the pain) Clinical Rating Assessment It is important to exclude acute arterial occlusion. History The history of the present illness should be to deal with continuous intensity, location, quality and temporal pattern of pain. Current injuries, excessive and / or unusual use and factors that increase pain (eg. As limb movement, walking) and relieve pain (eg. As suspended, certain positions) should be noted. Any associated neurological symptoms (eg. As numbness, paresthesia) should be identified. The system check should look for symptoms of possible causes, including back or neck pain (radiculopathy), fever (infections such as osteomyelitis, cellulitis or deep soft tissue infections), dyspnea (DVT with pulmonary embolism, MI) and chest pain or sweating (cardiac ischemia). The medical history should identify known risk factors, including cancer (metastatic bone tumors), the immune system debilitating diseases or substances (infections), Hyperkoagulationszustände (DVT), diabetes (peripheral vascular disease with limb ischemia), peripheral vascular disease, hypercholesterolemia and / or hypertension (acute or chronic ischemia), OA or RA (radiculopathy) and past violations (complex regional pain syndrome). Family and social history should at fever (with the family history of early vascular disease and cigarette smoking (limb or cardiac ischemia) and illegal use of parenteral (infections) befassen.Körperliche examination Vital signs are (suggestive of infection) and tachycardia and / or tachypnea rated compatible with DVT with pulmonary embolism, MI, and infection with sepsis). The painful limb is examined for color, edema and any skin or hair changes and pulses, temperature, tenderness and crepitus sampled (a subtle crackling feeling the gas in the soft tissue displays). Strength, sensation and tendon reflexes are compared between the affected and unaffected sides. The systolic blood pressure is measured in the ankle of the affected limb and compared to the systolic blood pressure of an arm. The ratio of the two is the ankle-brachial Index.Warnzeichen sudden, severe pain signs of acute ischemia of the extremity (z. B. Cool, pallor, pulse deficits, delayed capillary refill) dyspnea, chest pain and / or sweating signs of systemic toxicity (e.g. . B. delirium, tachycardia, shock, pallor) crepitus, tension, lazy discharge, blisters, necrosis risk factors for deep vein thrombosis Neurological deficits interpretation of the findings, it may be helpful to categorize patients according to severity of the symptoms and then narrow the differential diagnosis based on the presence or absence of findings of Cellulitis of the leg and foot © Springer Science + Business Media var model = {thumbnailUrl: ‘/-/media/manual/professional/images/25_cellulitis_slide_5_springer_high_de.jpg?la=de&thn=0&mw=350’ imageUrl: ‘/ – / media /manual/professional/images/25_cellulitis_slide_5_springer_high_de.jpg?la=de&thn=0 ‘, title:’ cellulitis of the leg and foot ‘, description:’ u003Ca id = “v37893512 ” class = “”anchor “” u003e u003c / a u003e u003cdiv class = “”para “” u003e u003cp u003eDiese figure shows the focal redness and swelling

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