Differential Diagnosis for Right Rib Pain in Pregnancy
Single Most Likely Diagnosis
- Musculoskeletal strain: Pregnancy can cause a shift in the center of gravity, leading to increased strain on the muscles and joints, including those in the rib cage. This strain can result in pain, especially on the right side where the liver and gallbladder are located, which may be more pronounced due to the enlarging uterus.
Other Likely Diagnoses
- Gallbladder disease: Pregnancy increases the risk of gallstones due to hormonal changes, particularly the increase in progesterone, which can slow down gallbladder emptying. Right rib pain can be a symptom of gallbladder disease, including cholecystitis or choledocholithiasis.
- Costochondritis: Inflammation of the cartilage that connects the ribs to the breastbone can cause sharp pains in the chest and rib area, which may be exacerbated by the physical changes of pregnancy.
- Rib fracture: Though less common, rib fractures can occur during pregnancy, especially if there has been trauma. The pain would be localized to the area of the fracture.
Do Not Miss Diagnoses
- Pulmonary embolism: A potentially life-threatening condition that requires immediate medical attention. Pregnancy increases the risk of blood clots, and pulmonary embolism can present with sudden onset of chest pain, including right rib pain.
- Pneumonia: Infection of the lungs that can cause chest pain, including pain that radiates to the ribs. Pregnancy can increase the risk of certain infections due to immune system changes.
- Cardiac conditions: Such as pericarditis or myocardial infarction, which are rare in pregnancy but can be life-threatening. Chest pain is a key symptom, and while it typically presents as central chest pain, it can radiate.
Rare Diagnoses
- Osteonecrosis: Also known as avascular necrosis, this condition involves the death of bone tissue due to a lack of blood supply. It can occur in any bone but is rare in the ribs. Pregnancy has been associated with an increased risk of osteonecrosis, possibly due to hormonal changes.
- Tietze's syndrome: A rare condition characterized by inflammation of the cartilages and surrounding tissues of the ribs, similar to costochondritis but can involve the swelling of the cartilage. It can cause severe pain in the chest and rib area.