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Increased tenderness in the left third intercostal space in adult patients with myalgic encephalomyelitis: a controlled study.

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By Puri BK, Gunatilake KD, Fernando KA, Gurusinghe AI, Agour M, Treasaden IH. • • January 1, 2011

A clinical sign has not thus far been associated with myalgic encephalo myelitis (ME). The present study involved systematic clinical examination that included inspection, palpation, percussion and auscultation of the thorax of 42 ME patients and 20 age-matched healthy controls while sitting. Left lateral third intercostal space tenderness was noted in 34 (81%) of the patients and in none of the controls, a difference that was highly statistically significant. This finding may be related to changes in lymphatic function and to the descending course of the thoracic duct. Further studies, preferably blinded and combined with appropriate imaging, are required.

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