Differential Diagnosis for Clicking Sound Right Sider Sternum with Movement Post Fall
Single Most Likely Diagnosis
- Sternocostal Joint Subluxation or Sprain: This condition is likely due to the trauma from the fall, causing a subluxation or sprain of the sternocostal joint, which can produce a clicking sound with movement. The lack of pain makes a more severe injury less likely, but the mechanical symptom of a clicking sound is consistent with a joint or musculoskeletal issue.
Other Likely Diagnoses
- Costochondritis: Although typically painful, costochondritis (inflammation of the cartilage that connects the ribs to the sternum) could potentially present with a clicking sound if the inflammation leads to joint instability or if the patient has a high pain tolerance. The post-fall context could have precipitated this condition.
- Rib Fracture with Non-Displaced Fragment: A small, non-displaced fragment of a rib fracture could cause a clicking sound as the fragment moves with breathing or movement. The fact that it's not painful could indicate a small, stable fragment.
Do Not Miss Diagnoses
- Pneumothorax: Although less likely given the lack of pain and the specific symptom of a clicking sound, a pneumothorax (collapsed lung) could potentially present with unusual symptoms, especially if small. The history of a fall necessitates consideration of this potentially life-threatening condition.
- Myocardial Contusion: Direct trauma to the chest can cause a myocardial contusion, which might not always present with typical chest pain, especially in the early stages. The clicking sound is unlikely to be directly related, but the context of the fall and the location of the sound near the sternum warrant consideration of cardiac injury.
Rare Diagnoses
- Slipping Rib Syndrome: This is a rare condition where the ribs slip out of place, causing a clicking or snapping sound. It's more common in the lower ribs but could potentially occur in any rib, including those near the sternum.
- Tietze's Syndrome: Similar to costochondritis but involves the inflammation of the cartilages and surrounding tissues of the upper ribs. It's rare and usually painful but could potentially present with a clicking sound in the absence of significant pain.