Differential Diagnosis for Pain over Costochondral Junction
- Single most likely diagnosis
- Costochondritis: This is the most common cause of pain over the costochondral junction, characterized by inflammation of the cartilage that connects the ribs to the breastbone. It is often related to repetitive strain or minor trauma.
- Other Likely diagnoses
- Tietze's syndrome: Similar to costochondritis but involves the inflammation of the cartilage and the surrounding tissues, including the muscles and tendons. It can cause sharp pains and tenderness.
- Musculoskeletal strain: Strain or overuse of the muscles in the chest wall can lead to pain in the costochondral junction area.
- Fibromyalgia: A chronic condition characterized by widespread musculoskeletal pain, including pain in the chest wall.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
- Acute coronary syndrome (ACS): Although less common, pain in the chest, including over the costochondral junction, can be a symptom of ACS, including myocardial infarction. It's crucial to rule out cardiac causes, especially in patients with risk factors.
- Pulmonary embolism: Sudden onset of chest pain, which can be localized to the costochondral junction, could be indicative of a pulmonary embolism, especially if accompanied by shortness of breath or other respiratory symptoms.
- Pneumonia or pleuritis: Infections or inflammation of the lung or pleura can cause chest pain that might be perceived over the costochondral junction.
- Rare diagnoses
- Sickle cell crisis: Patients with sickle cell disease can experience episodes of acute pain due to vaso-occlusive crises, which might manifest as chest pain.
- Hypertrophic cardiomyopathy: A rare heart condition that can cause chest pain, among other symptoms.
- Osteonecrosis or bone tumors: Although rare, these conditions can cause localized pain over the affected area, including the costochondral junction.