S20.449

Clinical Causes: Trauma or injury resulting in external pressure on the back wall of the thorax, such as in accidents or falls External compression from tumors or growths pressing against the back wall of the chest Application of constrictive dressings or devices post-surgery or injury Presence of external objects, such as tight clothing, bandages, or medical appliances causing constriction Structural deformities leading to external pressure on the thoracic back wall Infections that cause swelling or formation of abscesses exerting external pressure

Key Symptoms: Pain or discomfort in the back or chest region Difficulty breathing or shortness of breath due to restricted chest expansion Reduced chest wall mobility or stiffness Visible swelling or deformity on the back Possible skin changes if there is pressure necrosis or ulceration Swelling or bulging sensation in the affected area Palpable firmness or constriction upon physical examination

Diagnosis Path: X-rays of the thorax to identify any structural abnormalities or external pressures Computed tomography (CT) scans to provide detailed images of the chest wall and surrounding structures Magnetic resonance imaging (MRI), especially if soft tissue or muscle involvement is suspected Physical assessment to evaluate the extent of constriction and potential impact on respiratory function

Treatment Protocols: Addressing underlying causes such as removing external objects or relieving compression Surgical intervention in cases of structural deformities, tumors, or persistent constriction Use of supportive devices or dressings to prevent further constriction or to protect the skin Pain management through appropriate medications Rehabilitation therapies to improve chest wall mobility and breathing capacity In cases involving trauma, stabilization and appropriate wound care are critical