Perimyocarditis presenting as thoracic spinal pain in a physiotherapy outpatient clinic–a case report

Objective: To highlight the necessity for on-going vigilance of serious pathology when assessing and managing people with spinal pain. Methods: A case report of a young male patient who sought physiotherapy treatment for his acute thoracic pain. Following physiotherapy assessment, it seemed unlikely that the pain was related to a musculoskeletal problem. Besides pain-induced vomiting, there were no overt signs of serious pathology. However, he had a family history of cardiac issues. The patient was referred back to his general practitioner (GP) for further assessment. Results: The patient was subsequently diagnosed with perimyocarditis following investigations and was treated accordingly. At 6, 12 and 24 months follow-up, he reported good health. Conclusions and impact statement: Physiotherapists must remain vigilant of serious pathology even if patients have been examined by other healthcare professionals. This case also raises the issue of whether ‘vascular profiling’ should be part of routine practice protocols.