Differential Diagnosis for Left Sternoclavicular Pain
Single Most Likely Diagnosis
- Costoclavicular syndrome: This condition, also known as thoracic outlet syndrome, involves compression of the nerves and/or blood vessels between the clavicle and the first rib or thoracic vertebra, leading to pain in the sternoclavicular region. The mild swelling in the anterior trapezius region and the location of the pain are consistent with this diagnosis.
Other Likely Diagnoses
- Tendinitis or strain of the sternoclavicular joint or surrounding muscles: Given the acute onset of pain and the presence of mild swelling, inflammation or strain of the muscles or tendons around the sternoclavicular joint could be a plausible explanation.
- Clavicle fracture or stress fracture: Although the patient has full range of motion, a hairline or stress fracture could still cause pain and swelling without significantly limiting movement.
- Musculoskeletal strain: The pain could be due to a strain of the muscles in the region, such as the trapezius or pectoralis muscles, possibly from overuse or direct trauma.
Do Not Miss Diagnoses
- Pulmonary embolism: Although less likely given the location and nature of the pain, pulmonary embolism can sometimes present with chest pain that might be referred to the sternoclavicular region. It's crucial to consider this diagnosis due to its high mortality rate if missed.
- Aortic dissection: This is a life-threatening condition that can cause severe, sudden pain, often described as tearing, which can be referred to the chest or back. Early diagnosis is critical.
- Myocardial infarction: Chest pain is a common presentation of myocardial infarction, and while the location might not be typical, it's essential to rule out cardiac causes, especially in patients with risk factors.
Rare Diagnoses
- Sternoclavicular joint infection or septic arthritis: This would be an unusual presentation without significant trauma, fever, or other systemic symptoms, but it remains a possibility, especially if the patient is immunocompromised.
- Tumor or metastasis: A tumor in the sternoclavicular region or metastasis to the clavicle could cause pain and swelling. This would be less likely without a known history of cancer or systemic symptoms.
- Osteonecrosis of the clavicle: A rare condition that could cause pain in the sternoclavicular region, often without a clear precipitating factor.