Differential Diagnosis for Middle Back Pain with Redness and Breast Tenderness
- Single Most Likely Diagnosis
- Shingles (Herpes Zoster): This condition often presents with a painful rash, typically on one side of the body, which can include the middle back. The rash usually starts as small bumps that resemble pimples and can be red. Breast tenderness could be referred pain or a separate issue, but the primary symptom of a painful rash makes shingles a strong candidate.
- Other Likely Diagnoses
- Costochondritis: Inflammation of the cartilage that connects the ribs to the breastbone can cause pain in the chest and back, which might radiate to the breasts. While it doesn't typically cause a rash, the pain description and breast involvement make it a consideration.
- Precordial Catch Syndrome: This condition causes sharp pains in the chest that can radiate to the back and might be accompanied by tenderness in the breast area. However, it doesn't usually present with a rash.
- Acne or Folliculitis: If the "small bumps" are indeed pimples, a skin condition like acne or folliculitis could be the cause of the back symptoms. Breast pain could be unrelated or due to a separate condition like mastitis or a breast cyst.
- Do Not Miss Diagnoses
- Breast Cancer with Metastasis: Although less likely, it's crucial not to miss breast cancer, especially if there's a new onset of breast pain. Metastasis to the spine or skin could potentially cause back pain and skin lesions, though this would be an uncommon initial presentation.
- Inflammatory Breast Cancer: This rare and aggressive form of breast cancer can cause skin changes, including redness and bumps, and might be accompanied by pain in the breast and back due to its rapid progression.
- Endocarditis or Infective Emboli: In rare cases, an infection of the heart valves (endocarditis) can lead to emboli that cause skin lesions and might result in back pain if the emboli affect the spinal cord or if there's an associated infection like osteomyelitis.
- Rare Diagnoses
- Sarcoidosis: A condition that can cause inflammation in various parts of the body, including the skin, lungs, and lymph nodes. It might present with skin lesions and could potentially cause back and breast pain, though this would be an unusual combination of symptoms.
- Erythema Multiforme: A skin condition characterized by target lesions, which could be described as "small bumps" or a rash. It's often associated with infections or medications and could potentially cause the described symptoms, though breast pain would be an unusual associated symptom.