Differential Diagnosis for Right Posterior Pain with Inspiration
- Single most likely diagnosis
- Pleurisy: This condition, which is inflammation of the pleura (the two-layered membrane surrounding the lungs and lining the chest cavity), is a common cause of sharp chest pain that worsens with deep breathing or coughing. The pain is typically localized to the area of the inflamed pleura and can be unilateral, making it a likely explanation for right posterior pain with inspiration.
- Other Likely diagnoses
- Pulmonary Embolism (PE): While not as common as pleurisy, PE can cause sudden onset of chest pain that worsens with deep breathing. The pain can be sharp and stabbing, and its location can vary, including the posterior chest.
- Pneumonia: Inflammation of the lung tissue can cause pain that is worsened by deep breathing or coughing. The pain can be localized to the area of the lung affected by the pneumonia.
- Costochondritis: Inflammation of the cartilage that connects the ribs to the breastbone can cause sharp pains in the chest that may worsen with movement or deep breathing, including inspiration.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
- Pneumothorax: A collapsed lung can cause sudden, severe chest pain that worsens with breathing. It's a medical emergency that requires immediate attention.
- Aortic Dissection: A tear in the aorta's inner layer can cause severe, tearing chest pain that can radiate to the back. It's a life-threatening condition that requires immediate medical intervention.
- Myocardial Infarction (MI): Although more commonly associated with anterior chest pain, an MI can occasionally present with atypical pain patterns, including posterior chest pain.
- Rare diagnoses
- Pulmonary Infarction: If a pulmonary embolism causes infarction of lung tissue, it can lead to severe pain.
- Diaphragmatic Irritation: Conditions affecting the diaphragm, such as a diaphragmatic hernia or irritation from abdominal contents, can cause referred pain to the posterior chest.
- Vertebral Fracture or Osteoporosis: In rare cases, vertebral fractures or osteoporosis can cause pain that is exacerbated by breathing movements due to the mechanical stress on the spine.