Differential Diagnosis for Right Front Lower Rib and Colicky Flank Pain
Single Most Likely Diagnosis
- Musculoskeletal strain: This is often the most common cause of rib and flank pain, especially if the pain is colicky and not persistent. It could be due to overuse, injury, or poor posture.
Other Likely Diagnoses
- Costochondritis: Inflammation of the cartilage that connects the ribs to the breastbone can cause sharp pains in the chest and flank area, which might be exacerbated by movement or deep breathing.
- Nephrolithiasis (Kidney Stones): Although the pain from kidney stones is typically more persistent and severe, smaller stones might cause intermittent, colicky pain in the flank that radiates to the lower rib area.
- Pulmonary issues (e.g., Pneumonia, Pleurisy): Infections or inflammation of the lung or pleura can cause sharp, stabbing pains that might be felt in the chest and flank area, especially if the lower lobes are involved.
Do Not Miss Diagnoses
- Pulmonary Embolism: A life-threatening condition where a blood clot lodges in the lungs, which can cause sudden, severe chest pain that might radiate to the flank area. Although less common, it's critical to rule out due to its high mortality rate.
- Aortic Dissection: A tear in the aorta's inner layer can cause severe, tearing pain in the chest that might radiate to the back or flank area. It's a medical emergency requiring immediate attention.
- Appendicitis (if atypical presentation): Although appendicitis typically presents with right lower quadrant abdominal pain, atypical presentations can occur, and it's crucial not to miss this diagnosis due to its potential for serious complications.
Rare Diagnoses
- Tuberculosis: Can cause chronic pain in the chest and flank area due to infection of the lungs or kidneys.
- Sickle Cell Crisis: Individuals with sickle cell disease can experience episodes of severe pain due to vaso-occlusive crises, which might affect various parts of the body, including the chest and flank area.
- Herpes Zoster (Shingles): Reactivation of the varicella-zoster virus can cause a painful rash that might be preceded by pain in the affected dermatome, potentially involving the chest or flank area.