Differential Diagnosis for 28-year-old Male with Right Side Rib Pain
- Single most likely diagnosis
- Musculoskeletal strain: The patient's history of frequent gym visits and the nature of the pain (worsening with deep breathing) suggest a musculoskeletal origin, possibly a strain or pull in the intercostal muscles or rib cage.
- Other Likely diagnoses
- Costochondritis: Inflammation of the cartilage that connects the ribs to the sternum, which can cause chest pain that radiates to the back and worsens with deep breathing.
- Intercostal muscle strain: Similar to musculoskeletal strain, but more specifically involving the muscles between the ribs.
- Rib fracture: Although the patient does not recall an injury, a stress fracture or an occult fracture could be possible, especially given the patient's frequent gym visits.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
- Pulmonary embolism: A life-threatening condition that can cause sudden onset of chest pain that worsens with deep breathing, although it is less likely in a young, otherwise healthy individual.
- Pneumothorax: A collapsed lung that can cause sudden onset of chest pain and shortness of breath, which would be a medical emergency.
- Myocardial infarction: Although rare in young individuals, a heart attack can cause chest pain that radiates to the back and worsens with deep breathing.
- Rare diagnoses
- Sickle cell crisis: If the patient has sickle cell disease, a crisis could cause severe chest pain due to vaso-occlusion.
- Osteomyelitis: An infection of the bone that could cause pain and inflammation in the rib cage, although this would be unusual without a clear source of infection.
- Tietze's syndrome: A rare condition characterized by inflammation of the cartilage and surrounding tissues in the chest wall, which can cause chest pain and swelling.