Differential Diagnosis for a Lump in the Lower Part of the Sternum
Single Most Likely Diagnosis
- Costochondritis or Tietze's Syndrome: This condition, characterized by inflammation of the cartilage that connects the ribs to the sternum, is a common cause of chest pain and lumps, especially after trauma. The xiphoid process, being part of the sternum, could be involved, presenting as a lump in the lower part of the sternum.
Other Likely Diagnoses
- Xiphoid Process Abnormalities: As mentioned, abnormalities such as a bony growth or inflammation of the xiphoid process could present as a lump. These are less common but should be considered, especially if there's a history of trauma or if the lump is localized to the xiphoid area.
- Sternal Fracture or Contusion: Direct trauma to the chest can cause a fracture or contusion of the sternum, including the xiphoid process, leading to a palpable lump.
- Musculoskeletal Issues: Strains or pulls in the muscles attached to the sternum or xiphoid process could also present as a lump or swelling in the area.
Do Not Miss Diagnoses
- Cardiac Conditions: Although less likely to present as a lump, conditions such as pericarditis (inflammation of the sac surrounding the heart) could potentially cause chest pain or swelling that might be mistaken for a lump in the lower sternum. Missing a cardiac condition could be fatal.
- Pulmonary Embolism: While not typically presenting as a lump, severe chest pain and other symptoms could be confused with those of a sternum or xiphoid process issue. Pulmonary embolism is a life-threatening condition that requires immediate attention.
Rare Diagnoses
- Sternal Tumors: Both benign and malignant tumors can occur in the sternum, including the xiphoid process. These are rare and would typically be considered after more common causes have been ruled out.
- Infectious Processes: Osteomyelitis (infection of the bone) or septic arthritis (infection of a joint) involving the xiphoid process or sternum could present as a lump or swelling, although these are uncommon.
- Congenital Anomalies: Certain congenital conditions affecting the development of the sternum or xiphoid process could potentially cause abnormalities that might be noticed later in life as a lump.