Differential Diagnosis for Sternal Pain
- Single most likely diagnosis
- Costochondritis: This is the most common cause of sternal pain, characterized by inflammation of the cartilage that connects the ribs to the sternum. It is often related to trauma, overuse, or viral infections.
- Other Likely diagnoses
- Musculoskeletal strain: Strain or pull of the muscles or tendons in the chest wall can cause sternal pain, often related to heavy lifting, bending, or sudden movements.
- Gastroesophageal reflux disease (GERD): Stomach acid reflux can cause pain in the chest, including the sternum, especially after eating or at night.
- Sternal fracture: A break in the sternum, often due to trauma, can cause severe sternal pain.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
- Acute coronary syndrome (ACS): Although less common, ACS, including myocardial infarction, can present with sternal pain, especially if it radiates to the arms, neck, or jaw, and is accompanied by shortness of breath or diaphoresis.
- Pulmonary embolism: A blood clot in the lungs can cause sudden, severe sternal pain, often accompanied by shortness of breath, cough, or syncope.
- Aortic dissection: A tear in the aorta can cause severe, tearing sternal pain, often radiating to the back, and can be life-threatening if not promptly treated.
- Rare diagnoses
- Tietze's syndrome: A rare inflammatory condition that affects the cartilage of the ribs, causing sternal pain and swelling.
- Sternal osteomyelitis: A rare infection of the sternum, often due to bacterial or fungal causes, which can cause sternal pain, fever, and swelling.
- Sternal tumors: Rarely, tumors such as osteosarcoma or chondrosarcoma can cause sternal pain, often accompanied by a palpable mass or weight loss.