Differential Diagnosis for Sharp Right Sided Lower Chest Pain with Deep Inspirations

Single Most Likely Diagnosis

• Pleurisy: This condition, characterized by inflammation of the pleura, is a common cause of sharp chest pain that worsens with deep breathing. The pain is typically unilateral and can be accompanied by other symptoms such as cough or fever, depending on the underlying cause.

Other Likely Diagnoses

• Pulmonary Embolism (PE): Although less common in young individuals without risk factors, PE can present with sudden onset of sharp chest pain that worsens with deep inspiration (pleuritic chest pain). Other symptoms might include dyspnea, tachypnea, and cough.
• Pneumonia: Inflammation of the lung tissue can cause sharp chest pain, especially if the pneumonia involves the lower lobes and irritates the pleura. Symptoms often include fever, cough, and shortness of breath.
• Costochondritis: Inflammation of the cartilage that connects the ribs to the sternum can cause sharp chest pain, which may worsen with deep breathing or movement. It's more common in younger individuals and can be bilateral or unilateral.

Do Not Miss Diagnoses

• Pneumothorax: A potentially life-threatening condition where air leaks into the space between the lung and chest wall, causing the lung to collapse partially or completely. Symptoms can include sudden onset of sharp chest pain and shortness of breath. It's crucial to diagnose promptly as it may require emergency intervention.
• Cardiac Conditions (e.g., Pericarditis, Myocardial Infarction): Although less common in young females, cardiac conditions can present with chest pain. Pericarditis, inflammation of the sac surrounding the heart, can cause sharp chest pain that may improve with sitting up and leaning forward. Myocardial infarction (heart attack) is rare in this demographic but would be catastrophic if missed.

Rare Diagnoses

• Pulmonary Laceration: A tear in the lung tissue, which could be due to trauma. It might present with sharp chest pain and other symptoms like hemoptysis or shortness of breath.
• Diaphragmatic Injury: An injury to the diaphragm, which could be traumatic or spontaneous, leading to sharp lower chest pain, especially with deep inspiration or certain movements.
• Esophageal Rupture or Perforation: A rare but serious condition that could present with severe chest pain, often accompanied by difficulty swallowing, vomiting, or fever, depending on the cause and location of the rupture.