Differential Diagnosis for Ongoing Rib Pain
Single most likely diagnosis
- Rib fracture: Given the patient's history of a fall in February and ongoing rib pain on the left side, a rib fracture is the most likely diagnosis. The fact that the study is nonacute suggests that the fracture may be healing, but still causing pain.
Other Likely diagnoses
- Costochondritis: Inflammation of the cartilage that connects the ribs to the breastbone can cause rib pain, especially if the patient has been experiencing increased stress or activity on the left side.
- Musculoskeletal strain: The fall in February could have caused a strain to the muscles or ligaments surrounding the ribs, leading to ongoing pain.
- Intercostal neuralgia: Irritation or damage to the nerves that run between the ribs can cause sharp, stabbing pain in the rib area.
Do Not Miss (ddxs that may not be likely, but would be deadly if missed)
- Pulmonary embolism: Although the lungs are clear and there is no pneumothorax, a pulmonary embolism can cause rib pain and is a potentially life-threatening condition that should not be missed.
- Aortic dissection: A tear in the aorta can cause severe chest or rib pain and is a medical emergency that requires immediate attention.
- Osteomyelitis: An infection of the bone can cause ongoing pain and is a serious condition that requires prompt treatment.
Rare diagnoses
- Tietze's syndrome: A rare condition characterized by inflammation of the cartilage that connects the ribs to the breastbone, causing chest pain and tenderness.
- Sickle cell disease: A genetic disorder that can cause episodes of severe pain, including rib pain, due to sickling of red blood cells.
- Rib tumor: A rare tumor that can cause rib pain, such as a osteochondroma or a chondrosarcoma.