Musculoskeletal strain or injury: This is a common cause of rib pain in adolescents, often due to sports injuries, falls, or overuse. The age and presentation make this a plausible first consideration.

Costochondritis: Inflammation of the cartilage that connects the ribs to the breastbone, which can cause sharp pains in the chest or rib area. It's a common condition in adolescents.
Precordial catch syndrome: A condition characterized by sudden, sharp chest pain, often related to the ribs or chest wall, which can be recurrent and is common in adolescents.
Pulmonary causes (e.g., pneumonia, pleurisy): Although less common, respiratory infections can cause rib pain due to inflammation of the pleura.

Pneumothorax: A potentially life-threatening condition where air leaks into the space between the lung and chest wall, which can cause sudden, severe chest or rib pain.
Osteomyelitis or rib fracture: Infections of the bone or fractures can cause severe pain and have significant implications if not treated promptly.
Cardiac causes (e.g., pericarditis, myocardial infarction): Although rare in adolescents, cardiac conditions can present with chest or rib pain and are critical to diagnose early.

Tietze's syndrome: A rare condition characterized by inflammation of the cartilages and surrounding tissues of the ribs, similar to costochondritis but can involve the muscles as well.
Sickle cell crisis: In patients with sickle cell disease, a crisis can cause severe pain, including rib pain, due to vaso-occlusion.
Tumor (e.g., Ewing's sarcoma, osteosarcoma): Although rare, tumors can cause rib pain and are important to consider in the differential diagnosis, especially with persistent or worsening symptoms.