Differential Diagnosis
When considering the symptoms described, the following differential diagnoses can be organized into categories:
- Single most likely diagnosis
- Costochondritis: This condition, which involves inflammation of the cartilage that connects the ribs to the breastbone, can cause pain when pressing on the chest or ribs. The pain is typically sharp and can be exacerbated by movement or pressure.
- Other Likely diagnoses
- Musculoskeletal strain: Strain or injury to the muscles or ligaments in the back or rib area could cause pain upon touch or pressure. This is a common issue, especially if the individual has recently engaged in unusual physical activity.
- Rib fracture: A fracture in one of the ribs could cause significant pain, especially when the area is touched or pressed. This would be more likely if there was a history of trauma.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
- Pulmonary embolism: Although less likely, a pulmonary embolism (a blood clot in the lungs) can cause chest pain that worsens with deep breathing or movement. It's critical to consider this diagnosis due to its high mortality rate if untreated.
- Pneumothorax: A collapsed lung can cause sharp chest pain that worsens with movement or deep breathing. This condition requires immediate medical attention.
- Rare diagnoses
- Tietze's syndrome: A rare condition characterized by inflammation of the cartilages and surrounding tissues of the ribs. It can cause severe pain in the chest area.
- Sickle cell crisis: In individuals with sickle cell disease, a crisis can cause severe pain episodes, including pain in the chest or back due to vaso-occlusive episodes affecting the bones or lungs.
Each of these diagnoses has a different level of urgency and required treatment, emphasizing the importance of a thorough medical evaluation to determine the cause of the symptoms.