Limb Pain

Pain may arise from any anatomical structure features:

BONE - diffuse, aching pain BLOOD

± palpable mass.

JOINTS - pain localised to affected joint.

- tenderness on palpation.

- movements restricted and painful.

- wasting of surrounding muscles may follow.

MUSCLES - pain localised to specific muscle ± wasting and weakness + palpable mass.

within the limb. Each produces characteristic

VESSELS - pain brought on by exertion

(claudication), relieved by rest.

- pain at rest in pale, pulseless limb

(occlusion).

- pain associated with paresthesia and digital pallor (Raynaud's).

NERVE ROOT - pain increased by coughing or by movement ± associated neurological deficit

TENDONS - pain localised to swollen, tender tendon sheath.

CAUSES OF UPPER LIMB PAIN

PLEXUS OR PERIPHERAL NERVE- burning pain + sweating, cyanosis and oedema of extremity, ± associated neurological deficit.

Brachial plexus

- cervical rib/band

- apical bronchial ca.

- brachial neuritis (neuralgic amyotrophy)

- postirradiation damage

- neurofibroma

Tendon

- acute and chronic tenosynovitis

Blood vessels

- thoracic outlet syndrome

- collagen vascular disease

- paraproteinaemia

Peripheral nerve

- partial nerve injury

- peripheral neuropathy

- carpal tunnel syndrome

- ulnar nerve entrapment

Nerve root

- cervical spondylosis/disc

- malignant extradural tumour

- neurofibroma/meningioma

Muscle

- polymyositis 1 weakness

- polymyalgia > and rheumatica J wasting

- tumour - rhabdomyo-1 sarcoma, desmoid > mass

- myositis ossificans

Bone

- osteomalacia

- tumours -benign: osteoma/chondroma malignant: osteogenic sarcoma myeloma, metastasis

- osteomyelitis

Tendon

- acute and chronic tenosynovitis

Referred pain

- pleura

- heart (left arm)

Joints

- calcific tendinitis

- rotator cuff tear

- bursitis

- osteoarthritis

- rheumatoid arthritis

- infective arthritis

- tennis elbow (periarticular)

Blood vessels

- thoracic outlet syndrome

- collagen vascular disease

- paraproteinaemia

Peripheral nerve

- partial nerve injury

- peripheral neuropathy

- carpal tunnel syndrome

- ulnar nerve entrapment

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