Differential Diagnosis for Right Side Chest Radiating to Neck

• Single most likely diagnosis
  • Musculoskeletal strain: This is often the most common cause of chest pain radiating to the neck, especially if the pain is exacerbated by movement or deep breathing. The pain can be sharp and stabbing, and it may be related to overuse or strain of the muscles in the chest and neck.
• Other Likely diagnoses
  • Gastroesophageal reflux disease (GERD): GERD can cause chest pain that radiates to the neck, especially after eating or at night. The pain is often burning in nature and can be accompanied by symptoms like heartburn and regurgitation.
  • Costochondritis: This is an inflammation of the cartilage that connects the ribs to the breastbone. It can cause sharp pains in the chest that radiate to the neck, especially with deep breathing or movement.
  • Pulmonary embolism (less likely but possible): While less common, a pulmonary embolism can cause sudden onset of chest pain that radiates to the neck, especially if the embolism is large and affects the upper parts of the lung.
• Do Not Miss diagnoses
  • Myocardial infarction (heart attack): Although the pain of a heart attack typically presents in the center of the chest, it can radiate to the neck, especially on the right side. It's crucial to consider this diagnosis, especially in patients with risk factors for coronary artery disease.
  • Aortic dissection: This is a tear in the inner layer of the aorta. It can cause severe, tearing chest pain that radiates to the neck and back. It's a medical emergency that requires immediate attention.
  • Pneumothorax: A collapsed lung can cause sudden onset of chest pain that radiates to the neck, especially if the pneumothorax is large. It's more common in tall, thin males or in patients with underlying lung disease.
• Rare diagnoses
  • Pneumomediastinum: This is air in the mediastinum (the central part of the chest cavity) and can cause chest pain that radiates to the neck. It's often associated with trauma or lung disease.
  • Esophageal rupture: A tear in the esophagus can cause severe chest pain that radiates to the neck, often accompanied by difficulty swallowing and severe pain with eating.
  • Thoracic outlet syndrome: This condition involves compression of the nerves and/or blood vessels that pass into the thoracic outlet (the space between your collarbone and first rib). It can cause pain in the chest and neck, especially with movement of the arm.