Differential Diagnosis for Bilateral Chest Wall Hyperesthesia
Single Most Likely Diagnosis
- Shingles (Herpes Zoster): This is a common condition that can cause hyperesthesia, especially if the patient has a history of herpes zoster infection. The pain and sensitivity can precede the rash, making it a likely diagnosis for bilateral chest wall hyperesthesia.
Other Likely Diagnoses
- Costochondritis: Inflammation of the cartilage that connects the ribs to the breastbone can cause pain and hyperesthesia in the chest wall.
- Musculoskeletal strain: Overuse or injury to the muscles and tendons in the chest wall can lead to hyperesthesia and pain.
- Fibromyalgia: A chronic condition characterized by widespread muscle pain and tender points, which can include the chest wall.
- Anxiety or stress: Can cause or exacerbate hyperesthesia and other sensory symptoms in the chest wall.
Do Not Miss Diagnoses
- Myocardial infarction: Although less likely to cause bilateral hyperesthesia, it is a life-threatening condition that should not be missed. Some patients may experience referred pain or hyperesthesia in the chest wall during a heart attack.
- Pulmonary embolism: Another life-threatening condition that can cause sudden onset of chest pain and hyperesthesia, especially if the embolism is large or involves multiple lung segments.
- Pneumothorax: A collapsed lung can cause sudden onset of chest pain and hyperesthesia, especially if the pneumothorax is large or under tension.
Rare Diagnoses
- Sjögren's syndrome: An autoimmune disorder that can cause neuropathic pain and hyperesthesia in various parts of the body, including the chest wall.
- Multiple sclerosis: A chronic autoimmune disorder that can cause a wide range of neurological symptoms, including hyperesthesia and pain in the chest wall.
- Neoplastic conditions: Rarely, tumors such as lymphoma or metastatic cancer can cause hyperesthesia and pain in the chest wall.
- Peripheral neuropathy: Certain types of peripheral neuropathy, such as diabetic neuropathy or neuropathy due to vitamin deficiencies, can cause hyperesthesia and pain in the chest wall.