Differential Diagnosis for Posterior Rib Pain
Single most likely diagnosis
- Musculoskeletal strain or costochondritis: This condition is likely due to the localized nature of the pain, which is exacerbated by breathing in and the elevation of the right back. The pain associated with musculoskeletal strain or costochondritis can be sharp and worsen with movement or deep breathing.
Other Likely diagnoses
- Precordial catch syndrome: This condition is characterized by sharp, stabbing pain in the chest or back that can be exacerbated by deep breathing. It's a relatively common and benign condition but can be alarming due to its intensity.
- Rib fracture or stress fracture: Although less common without a history of trauma, a stress fracture could cause localized pain that worsens with movement or deep breathing.
- Intercostal muscle strain: Strain in the muscles between the ribs can cause pain that is exacerbated by breathing and movement.
Do Not Miss (ddxs that may not be likely, but would be deadly if missed)
- Pulmonary embolism: Although the pain is localized to one side and worsens with breathing, pulmonary embolism is a life-threatening condition that must be considered, especially if there are other symptoms like shortness of breath or recent immobility.
- Pneumothorax: A collapsed lung can cause sharp chest pain that worsens with breathing. It's a medical emergency that requires immediate attention.
- Myocardial infarction: Though less likely with localized back pain, myocardial infarction can sometimes present with atypical symptoms, including back pain.
Rare diagnoses
- Tietze's syndrome: A rare inflammatory condition affecting the cartilages and surrounding tissues of the ribs, which can cause localized pain and swelling.
- Scoliosis or kyphosis: Although these are more chronic conditions, acute exacerbations or previously undiagnosed cases could present with back pain and uneven elevation of the back.
- Osteomyelitis or bone infection: Infection of the bone can cause localized pain, but this would typically be accompanied by other symptoms like fever or redness.