Symptom Spacers

Dear colleagues, today we will look at a symptom that is often encountered in the practice of a general practitioner and family doctor. This symptom occurs when a muscle or ligament is stretched (including, for example, the subscapularis muscle - adductor), which causes the shoulder blades to move closer together and the shoulder to dislocate. This syndrome is diagnosed especially simply - just ask the patient to spread his arms with palms up or to the sides and look in this position at the front surface of his chest. If the patient bends in such a way that the shoulder blades come as close to each other as possible, and a pronounced longitudinal groove appears along the axis from the clavicle to the xiphoid process, then the diagnosis is clear - the Tripod symptom, also known as the Rapport symptom. The reason for this symptom is clear: there is tension in the subscapularis muscles, i.e. stretching In this case, pain is observed in the subscapular region, in front and below it, where the muscle fibers of the anterolateral surface of the forearm and the posterior group of muscles of the upper limb go. When the doctor palpates this area, you can expect sharp pain. This definition in real medical practice raises questions: is this syndrome really called that? This question worries both physiotherapists and neurologists, who find completely different explanations for the pain syndrome, trying to explain it by psychogenic factors or manifestations of neurology. Let's consider several theoretical and practical explanations of the terminology of Rapport syndrome, based on publications by doctors from different countries. Based on a retrospective review of the literature in recent years, it was found that in 20% of cases, dissonance is possible between the results of a physical examination and the unemotional responses of a patient complaining of sharp pain along the muscle. Many patients with spinal pathology simultaneously experience pain in the neck and anterolateral muscle group of the forearm. Thus, from the presented analysis it becomes clear that if there is soft tissue swelling in the anterior palate