Differential Diagnosis for Lower Rib Pain
- Single most likely diagnosis
- Musculoskeletal strain: This is the most common cause of lower rib pain, often resulting from overuse, trauma, or poor posture. The pain is typically sharp and worsens with movement or deep breathing.
- 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 triggered by deep breathing or movement.
- Gastroesophageal reflux disease (GERD): Stomach acid reflux can cause pain in the lower chest and rib area, especially after eating or at night.
- Pulmonary embolism (less common, but important to consider): A blood clot in the lungs can cause sudden, severe chest pain, including lower rib pain.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed)
- Pneumonia: Infection in the lungs can cause lower rib pain, especially if the infection is located in the lower lobes.
- Pulmonary embolism: As mentioned earlier, a blood clot in the lungs can be life-threatening and requires immediate medical attention.
- Cardiac ischemia or myocardial infarction: Although less common, cardiac conditions can cause referred pain in the lower rib area.
- Sickle cell crisis: Individuals with sickle cell disease can experience severe pain episodes, including lower rib pain, due to vaso-occlusive crises.
- Rare diagnoses
- Tietze's syndrome: A rare condition characterized by inflammation of the cartilage in the chest, causing pain and swelling in the rib area.
- Spondyloarthritis: A group of inflammatory diseases that can cause pain and stiffness in the spine, ribs, and other joints.
- Osteoporotic rib fracture: Weakened bones can increase the risk of rib fractures, which can cause lower rib pain.
- Thoracic spine fracture or herniated disk: Trauma or degenerative changes in the thoracic spine can cause lower rib pain due to referred pain or nerve compression.