Ultrasound diagnosis and treatment of intractable anterior chest pain from golf - A case report –

BACKGROUND: Pleurisy is an inflammation of the parietal pleura and is characterized by pleuritic pain. The most common cause of pleurisy is infection; other causes include rheumatoid arthritis, malignancy, rib fractures, or trauma. Possible causes of chest pain associated with golf include costochondritis, stress fractures of the ribs, intercostal muscle strain, or, rarely, Tietze’s syndrome and slipping rib syndrome. CASE: A 64-year-old female presented with intractable chest pain that began 4 months prior while playing golf. No specific cause was found after various examinations. There was persistent pain despite medical treatment. Ultrasonography (US) was performed over the painful areas, which revealed focal pleural effusions. A mixture of ropivacaine and triamcinolone was injected into the focal pleural effusions using US guidance, which dramatically relieved her pain. CONCLUSIONS: This case demonstrates that US can be used as a diagnostic and therapeutic modality for intractable chest pain with an undetected pathology.