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Chest X-rays may show air in the mediastinum, the middle of the chest cavity. [5] A significant case of subcutaneous emphysema can be detected by touching the overlying skin, which will feel like tissue paper or Rice Krispies. [8] Touching the bubbles causes them to move and sometimes make a crackling noise. [9]
The pain is agitated by expansion and contraction of the chest. Taking a deep breath and allowing the rib cage to fully expand can relieve the pain, however it will feel unpleasant initially. At the point of full expansion, it can feel like a rubber band snap in the chest, after which the initial pain subsides.
The defining symptom of pleurisy is a sudden sharp, stabbing, burning or dull pain in the right or left side of the chest during breathing, especially when one inhales and exhales. [9] It feels worse with deep breathing, coughing, sneezing, or laughing. The pain may stay in one place, or it may spread to the shoulder or back. [10]
Chest-wall defects are usually evident in cases of injury to the chest wall, such as stab or bullet wounds ("open pneumothorax"). In secondary spontaneous pneumothoraces, vulnerabilities in the lung tissue are caused by a variety of disease processes, particularly by rupturing of bullae (large air-containing lesions) in cases of severe emphysema.
Chest pain may present as a stabbing, burning, aching, sharp, or pressure-like sensation in the chest. [ 8 ] [ 1 ] Chest pain may also radiate, or move, to several other areas of the body. This may include the neck, left or right arms, cervical spine , back, and upper abdomen . [ 9 ]
Auscultation shows crackles or wheezing. Oxygen saturation usually shows hypoxemia. In most cases chest radiological examination shows signs of pulmonary edema, but a significant minority have a normal initial chest X-Ray. [3] Rapid resolution of initial signs and symptoms within 48 hours is typical.
Costochondritis, also known as chest wall pain syndrome or costosternal syndrome, is a benign inflammation of the upper costochondral (rib to cartilage) and sternocostal (cartilage to sternum) joints. 90% of patients are affected in multiple ribs on a single side, typically at the 2nd to 5th ribs. [1]
Even when only one side of the chest is injured, inflammation may also affect the other lung. [37] Uninjured lung tissue may develop edema, thickening of the septa of the alveoli, and other changes. [38] If this inflammation is severe enough, it can lead to dysfunction of the lungs like that seen in acute respiratory distress syndrome. [39]