Differential Diagnosis
- Single most likely diagnosis
- Costochondritis or rib fracture: The patient's history of forceful coughing and sneezing, followed by intermittent left rib pain that worsened over time, is consistent with a rib fracture or costochondritis. The patient's recent imaging showing nondisplaced anterior 5th, 6th, and 7th rib fractures supports this diagnosis.
- Other Likely diagnoses
- Musculoskeletal strain: The patient's symptoms of worsening discomfort with certain movements and coughing could also be consistent with a musculoskeletal strain.
- Precordial catch syndrome: This condition is characterized by sharp, stabbing chest pain that can be exacerbated by movement or deep breathing, which could be considered given the patient's symptoms.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
- Pulmonary embolism: Although the patient denies shortness of breath or chest pain, a pulmonary embolism could present atypically, especially in a patient with a history of cancer (CLL).
- Pneumonia or lung abscess: The patient's recent history of a cold/cough and current symptoms could be consistent with a pulmonary infection, which would require prompt treatment.
- Cardiac ischemia or myocardial infarction: The patient's history of hyperlipidemia and current symptoms of chest discomfort could be consistent with cardiac ischemia or myocardial infarction, although the patient denies typical symptoms.
- Rare diagnoses
- Osteomyelitis or rib osteonecrosis: These conditions could present with similar symptoms, although they are less likely given the patient's history and lack of systemic symptoms such as fever.
- Tietze's syndrome: This is a rare condition characterized by inflammation of the cartilages and surrounding tissues of the ribs, which could present with similar symptoms.