Differential Diagnosis for Lower Rib Pain
- Single most likely diagnosis
- Musculoskeletal strain: This is the most common cause of lower rib pain, often resulting from overuse, trauma, or poor posture. The pain is typically sharp and localized to the area of the strained muscle.
- Other Likely diagnoses
- Costochondritis: Inflammation of the cartilage that connects the ribs to the sternum, which can cause sharp pains in the lower rib area.
- Precordial catch syndrome: A benign condition characterized by sudden, sharp pains in the chest or lower rib area, often related to changes in position or breathing.
- Gastroesophageal reflux disease (GERD): Stomach acid reflux can cause pain in the lower rib area, especially after eating or at night.
- Pulmonary embolism (less common, but important to consider): A blood clot in the lungs can cause sudden, severe pain in the lower rib area, often accompanied by shortness of breath.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed)
- Pneumonia: Infection in the lungs can cause pain in the lower rib area, especially if the infection is located in the lower lobes.
- Pulmonary embolism: As mentioned earlier, a blood clot in the lungs can be life-threatening and requires immediate medical attention.
- Cardiac ischemia or myocardial infarction: Although less common, cardiac conditions can cause referred pain in the lower rib area.
- Sickle cell crisis: Individuals with sickle cell disease can experience severe pain episodes, including pain in the lower rib area.
- Rare diagnoses
- Osteoporotic fracture: Weakened bones can lead to fractures, including in the ribs, which can cause pain in the lower rib area.
- Tumor or metastasis: Rarely, a tumor or metastasis in the lung, rib, or surrounding tissue can cause lower rib pain.
- Sarcoidosis: A rare inflammatory disease that can affect the lungs and cause pain in the lower rib area.
- Thoracic spine fracture or herniated disk: Although less common, spinal issues can cause referred pain in the lower rib area.