Differential Diagnosis for Left Sided Rib Pain and Tenderness Associated with Cough
- Single Most Likely Diagnosis
- Musculoskeletal Strain: This is often the most common cause of rib pain and tenderness, especially when associated with coughing. The repeated strain from coughing can lead to muscle strain or even costochondral junction inflammation.
- Other Likely Diagnoses
- Pneumonia: Infection in the lung can cause pain that is referred to the ribs, especially if the pneumonia is localized to the lower lobes. The pain is often worsened by coughing.
- Pleurisy: Inflammation of the pleura, which can be due to various causes including viral infections, pneumonia, or pulmonary embolism, can cause sharp chest pain that worsens with deep breathing or coughing.
- Costochondritis: Inflammation of the cartilage that connects the ribs to the sternum, which can cause pain and tenderness, especially with movements like coughing.
- Do Not Miss Diagnoses
- Pulmonary Embolism: Although less common, pulmonary embolism is a life-threatening condition that can cause sudden onset of chest pain and shortness of breath. The pain can be worsened by coughing.
- Pneumothorax: A collapsed lung can cause sudden chest pain and shortness of breath, with pain often worsening with deep breathing or coughing.
- Cardiac Conditions (e.g., Myocardial Infarction): While less directly related to cough, cardiac conditions can cause chest pain that might be confused with rib pain, especially if the pain is referred.
- Rare Diagnoses
- Tietze's Syndrome: A rare inflammatory condition of the cartilages and surrounding tissues of the ribs, similar to costochondritis but can involve the joints between the ribs and the sternum.
- Rib Fracture: While not rare in the context of trauma, a spontaneous rib fracture due to coughing alone would be unusual and might suggest an underlying condition such as osteoporosis.
- Tumors: Both benign and malignant tumors affecting the ribs, lung, or pleura can cause localized pain and tenderness, though these would typically have additional symptoms and a more gradual onset.