Musculoskeletal chest wall syndromes in patients with noncardiac chest pain : a study of 100 patients

One hundred patients with chest pain and negative coronary arteriography were evaluated for musculoskeletal chest wall findings. Sixty-nine patients had chest wall tenderness. Typical chest pain was evoked by palpation in 16 patients. Tender areas were not found in a control group of patients without chest pain. A diagnosis of fibrositis could be made in five patients, including two in whom chest palpation reproduced typical chest pain. The sternal and xiphoid area, left costosternal junctions, and left anterior chest wall were the areas where tenderness was most common, but no significant differences were found comparing locations of tenderness in those with reproduction of typical pain. There was no significant difference in location, exacerbating factors, or other musculoskeletal symptoms among different groups of patients. Thus, most patients with noncardiac chest pain have chest wall tenderness that is not found in a control group without chest pain. However, reproduction of pain by palpation, a more specific diagnostic finding, is found in a minority of these patients.