What are the potential causes of thoracic and costal pain?

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Last updated: May 15, 2025View editorial policy

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Differential Diagnosis for Chest and Rib Pain

Single Most Likely Diagnosis

  • Musculoskeletal strain: This is often the most common cause of chest and rib pain, resulting from overuse, trauma, or poor posture. The pain is typically sharp and localized to the area of injury.

Other Likely Diagnoses

  • Costochondritis: Inflammation of the cartilage that connects the ribs to the sternum, causing sharp pains in the chest and rib area.
  • Precordial catch syndrome: A benign condition characterized by sudden, sharp pains in the chest and rib area, often related to changes in position or breathing.
  • Gastroesophageal reflux disease (GERD): Stomach acid reflux can cause chest pain and discomfort, which may radiate to the ribs.
  • Pulmonary embolism (less common, but important to consider): A blood clot in the lungs can cause sudden, severe chest pain and shortness of breath.

Do Not Miss Diagnoses

  • Myocardial infarction (heart attack): Chest pain can be a symptom of a heart attack, which requires immediate medical attention.
  • Pneumothorax: A collapsed lung can cause sudden, severe chest pain and shortness of breath.
  • Aortic dissection: A tear in the aorta can cause severe, tearing chest pain that radiates to the back.
  • Esophageal rupture: A tear in the esophagus can cause severe chest pain and difficulty swallowing.

Rare Diagnoses

  • Tietze's syndrome: A rare inflammatory condition that affects the cartilage of the ribs, causing chest and rib pain.
  • Sickle cell crisis: A condition that affects people with sickle cell disease, causing severe chest and rib pain due to sickling of red blood cells.
  • Osteoporotic fracture: A fracture of the ribs or spine due to osteoporosis, which can cause chest and rib pain.
  • Tumor or cancer: A rare cause of chest and rib pain, which can be due to a tumor or cancer affecting the lungs, ribs, or surrounding tissues.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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