Differential Diagnosis for Tendererness overlying Right Thoracic Dermatome T10-12
Single Most Likely Diagnosis
- Musculoskeletal strain or sprain: This is the most likely diagnosis due to the localized tenderness over the right thoracic dermatome T10-12 and the paravertebral area, which can be caused by muscle strain or sprain from heavy lifting, bending, or sudden movement.
Other Likely Diagnoses
- Costochondritis: Inflammation of the cartilage that connects the ribs to the sternum can cause tenderness in the thoracic area, especially if the T10-12 dermatomes are involved.
- Thoracic spine facet joint pain: Facet joint dysfunction or inflammation in the thoracic spine can cause localized pain and tenderness, particularly in the paravertebral area.
- Intercostal neuralgia: Irritation or compression of the intercostal nerves can cause sharp, stabbing pain and tenderness in the thoracic area, corresponding to the affected dermatome.
Do Not Miss Diagnoses
- Pulmonary embolism: Although less likely, pulmonary embolism can cause sudden, severe chest pain that may be referred to the thoracic dermatomes, and it is essential to rule out this life-threatening condition.
- Myocardial infarction: Chest pain or tenderness can be a symptom of myocardial infarction, especially if it radiates to the arm, neck, or jaw, and it is crucial to consider this diagnosis, even if the pain is localized to the thoracic dermatome.
- Pneumonia or pleurisy: Infection or inflammation of the lung or pleura can cause chest pain and tenderness, which may be referred to the thoracic dermatomes, and it is essential to rule out these conditions.
Rare Diagnoses
- Thoracic spine fracture: A fracture of the thoracic spine can cause localized pain and tenderness, especially if it involves the T10-12 vertebrae.
- Tumor or metastasis: A tumor or metastasis in the thoracic spine or surrounding tissues can cause localized pain and tenderness, although this is a less common cause of the symptoms.
- Herpes zoster: Reactivation of the varicella-zoster virus can cause shingles, which can manifest as a painful rash or tenderness in a dermatomal distribution, including the T10-12 dermatomes.