Symptom Finder - Girdle Pain
GIRDLE PAIN
Girdle pain is defined as radicular pain radiating around the trunk and anatomically would almost invariably signify involvement of the intercostal nerves or roots. The mnemonic MINT should bring to mind the commonest causes of this symptom.
M—Malformation would suggest syringomyelia.
I—Inflammation should suggest herpes zoster, tabes dorsalis, or epidural abscess.
N—Neoplasm prompts the recall of the spinal cord tumor involving the dorsal root.
T—Trauma would suggest not only vertebral or rib fractures but also a herniated thoracic disc, which although rare must be considered in the differential diagnosis.
Two conditions that may not be suggested by this mnemonic are multiple sclerosis and subacute combined degeneration of the spinal cord associated with pernicious anemia.
Approach to the Diagnosis
Routine laboratory tests such as a CBC, sedimentation rate, VDRL, and chemistry panel should be done but may not be revealing. Plain x-rays of the spine and ribs should be ordered especially if there is a history of trauma. If there is long tract or other signs of spinal cord involvement, an MRI may need to be done, but a neurologist should be consulted first.
Girdle pain is defined as radicular pain radiating around the trunk and anatomically would almost invariably signify involvement of the intercostal nerves or roots. The mnemonic MINT should bring to mind the commonest causes of this symptom.
M—Malformation would suggest syringomyelia.
I—Inflammation should suggest herpes zoster, tabes dorsalis, or epidural abscess.
N—Neoplasm prompts the recall of the spinal cord tumor involving the dorsal root.
T—Trauma would suggest not only vertebral or rib fractures but also a herniated thoracic disc, which although rare must be considered in the differential diagnosis.
Two conditions that may not be suggested by this mnemonic are multiple sclerosis and subacute combined degeneration of the spinal cord associated with pernicious anemia.
Approach to the Diagnosis
Routine laboratory tests such as a CBC, sedimentation rate, VDRL, and chemistry panel should be done but may not be revealing. Plain x-rays of the spine and ribs should be ordered especially if there is a history of trauma. If there is long tract or other signs of spinal cord involvement, an MRI may need to be done, but a neurologist should be consulted first.
