Differential Diagnosis for Crepitus on the Breast Bone
- Single most likely diagnosis
- Costochondritis: This is the most common cause of crepitus on the breast bone, which is an inflammation of the cartilage that connects the ribs to the breast bone. It can cause a grinding or creaking sensation, especially with movement.
- Other Likely diagnoses
- Tietze's syndrome: Similar to costochondritis but involves the inflammation of the cartilage and surrounding tissues, leading to swelling and pain.
- Fibromyalgia: A condition characterized by widespread musculoskeletal pain, including the chest area, which might cause crepitus due to muscle spasms or tender points.
- Osteoarthritis: Wear and tear of the joints, including those connecting the ribs to the breast bone, can lead to crepitus.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
- Pulmonary embolism: Although less common, a pulmonary embolism can cause sudden onset of chest pain and might be associated with crepitus if there is associated pneumothorax or pleural effusion.
- Pneumothorax: Air in the pleural space can cause crepitus under the skin (subcutaneous emphysema) if it extends beyond the lung boundaries.
- Aortic dissection: A tear in the aorta's inner layer can cause severe, tearing chest pain and might be associated with crepitus if there is mediastinal air.
- Rare diagnoses
- Sternal fracture: A break in the breast bone, which can occur from trauma, osteoporosis, or overuse, and might cause crepitus due to the movement of bone fragments.
- Sternal osteomyelitis: An infection of the breast bone, which is rare but can cause pain, swelling, and crepitus.
- Relapsing polychondritis: A rare autoimmune disorder that can cause inflammation of cartilage throughout the body, including the costal cartilages, leading to crepitus and other symptoms.