Unusual chest wall pain caused by thoracic disc herniation in a professional baseball pitcher

Abstract

Symptomatic thoracic disc herniation is clinically rare. There are few cases of disc herniation of the thoracic spine in top athletes described in the literature. We herein present a rare case of chest wall pain due to thoracic disc herniation in a professional baseball pitcher. A 30-year-old, left-handed pitcher complained of left-sided chest wall pain in the region of his lower ribs during a game. Neurological examination revealed hypoesthesia of the left side of the chest at the level of the lower thoracic spine. Magnetic resonance imaging (MRI) of the thoracic spine showed a left-sided paramedian disc herniation at the T9-T10 level. The player was initially prescribed rest, administration of pregabalin (150 mg twice a day), and subsequent physical rehabilitation. He was able to resume full training and pitching without medication 6 months after the onset. A follow-up MRI of the thoracic spine showed a reduction in the size of the herniated disc compared to the initial findings. Though relatively rare, thoracic disc herniation should be considered in cases of chest wall pain in athletes.

Fig. 1.

Initial MRI (T2-weighted, sagittal (A), parasagittal (B) and transverse(C)) of the thoracic spine, one month after the onset, showing at the T9-T10 level, a disc protrusion on the left side that deforms the dural sac but not the medulla.

Fig. 2.

Follow-up MRI (T2-weighted, sagittal (A), parasagittal (B) and transverse(C)) of the thoracic spine, 5 months after the onset, showing at the T9-T10 level, a slight paramedian disc protrusion on the left side.　The disc herniation had decreased in size.