What is the cause of asymmetric chest wall prominence, with the left rib cage being more prominent than the right in a female patient in her 60s?

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Differential Diagnosis for Prominent Left Rib Cage in a Female in her 60's

  • Single most likely diagnosis
    • Scoliosis: This is a common condition that can cause uneven rib cage prominence due to abnormal curvature of the spine. It can be idiopathic or secondary to other conditions like osteoporosis, which is prevalent in postmenopausal women.
  • Other Likely diagnoses
    • Fracture or trauma: Previous trauma to the chest or ribs can lead to uneven healing or malunion, causing one side of the rib cage to appear more prominent.
    • Musculoskeletal conditions: Conditions like fibromyalgia or muscular dystrophy can lead to uneven muscle development or wasting, affecting the appearance of the rib cage.
    • Respiratory conditions: Chronic conditions like pneumothorax or pleural effusion can cause uneven lung expansion, making one side of the rib cage appear more prominent.
  • Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
    • Lung cancer: Although less likely, lung cancer can cause localized destruction of the rib cage or spine, leading to uneven prominence.
    • Osteomyelitis or spinal infection: Infections of the spine or ribs can cause destruction or deformation of the bone, leading to uneven rib cage appearance.
    • Aortic aneurysm or dissection: Although rare, a thoracic aortic aneurysm or dissection can cause chest pain and uneven rib cage prominence due to the pressure exerted on surrounding structures.
  • Rare diagnoses
    • Neurofibromatosis: This genetic disorder can cause uneven bone growth and tumors that may affect the appearance of the rib cage.
    • Marfan syndrome: A genetic disorder that affects the body's connective tissue, potentially leading to skeletal abnormalities, including an uneven rib cage.
    • Poland syndrome: A rare congenital condition characterized by underdeveloped or missing muscles on one side of the body, which can affect the appearance of the rib cage.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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