Except for traumatic or spontaneous pneumothorax, little information is known about
exercise associated pleural pathologies. We present the case of a 22-year-old athlete
with symptoms of musculoskeletal disorders of his upper back after a first league
soccer match. Clinical examination initially showed a blockage of the costotransversal
joints six and seven with subsequent muscular tension representing an interscapulovertebral
pain syndrom. Temporary complete pain relief with following severe reoccurrence of
symptomes led to further diagnostic procedures after 3 days. Contrast Enhanced Magnetic
Resonance Images (CE-MRI) surprisingly revealed an intrathoracic tumenescence in front
of the cardiac apex with surrounding pleural effusion. After excluding all alternative
diagnosis for unclear pleurisy we assumed an exercise dependent local pleurisy with
subsequent pleural effusion due to local friction by a posttraumatic intrathoracic
hematoma. Several invasive and non-invasive therapeutical options were discussed in
this rare case with a final decision for a conservative strategy. Seven weeks after
injury the player was able to return to play. Even if musculoskeletal problems are
most likely in high impact athletes, referred pain due to less common disorders has
always to be kept in mind.
pleuritic pain - intrathoracic hematoma - pleural effusion - interscapulovertebral
syndrom - sports
