Subacute Pulmonary Embolism Masquerading as Musculoskeletal Thoracic Back Pain: A Case Report.

BACKGROUND

Thoracic back pain is an understudied clinical entity, and few evidence-based guidelines exist for its evaluation. Pulmonary embolism can present atypically with referred pain to the thoracic region if the visceral pleura becomes involved.

CASE REPORT: A patient presented to the interventional pain clinic with 6 weeks of worsening multifocal back pain. Conservative management addressed his cervical and lumbar pain but did not improve his thoracic symptoms. A pulmonary embolism was incidentally found while evaluating unrelated intraabdominal complaints. Anticoagulation fully resolved the thoracic component of his pain.

CONCLUSIONS

Pulmonary embolism is a major cause of death and disability worldwide, and delays in diagnosis are associated with poorer outcomes. Atypical cases like this one highlight the need for clinical practice guidelines on the diagnosis and management of thoracic back pain.