Rib pain

by Nathan Wei, MD, FACP, FACR

Nathan Wei is a nationally known board-certified rheumatologist and author of the Second Opinion Arthritis Treatment Kit. It's available exclusively at this website... not available in stores.

Click here: Second Opinion Arthritis Treatment Kit

Many different conditions can cause rib pain.

Common Causes of rib pain:

• Bruised, cracked, or fractured rib
• Costochondritis (inflammation of cartilage near the breastbone)
• Osteoporosis
• Pleurisy (the pain is worse when breathing deeply)

With a broken rib, the pain is definitely aggravated by bending and twisting the torso. With pleurisy (swelling of the lining of the lungs), it is not always.

Rib pain sometimes involves the chest. Some examples are:

• Costochondritis and Tietze's syndrome are both associated with tenderness of one or more of the costochondral joints. Tietze's syndrome is used to describe the combination of pain, tenderness and swelling, while costochondritis is used when swelling is absent.
• Sternalis syndrome is a rare disorder characterized by localized tenderness found over the sternum, accompanied by tenderness that radiates bilaterally.
• Xiphoidynia is a rare syndrome with localized pain and tenderness over the xiphoid process.
• Sternocostoclavicular hyperostosis is a syndrome characterized by an arthropathy that frequently involves the anterior chest wall and is associated with a spectrum of neutrophilic skin lesions. The acronym SAPHO syndrome has been proposed as a term to include the various features that may occur: synovitis; acne; pustulosis; hyperostosis; and osteomyelitis.
• Lower rib pain syndromes such as slipping or clicking rib syndrome, rib-tip syndrome, or twelfth rib have been described. Pain can be diffuse or localized, and is accompanied by tenderness on the rib margin.
• Fibromyalgia is a common chronic musculoskeletal pain syndrome that presents with diffuse myalgias, multiple tender points, sleep disturbance, and fatigue. Many patients report tenderness over the second costochondral junctions.

Rib pain may also be referred from internal organs such as the liver, gall bladder or heart.

Medical history is the key to diagnosis. Questions should include:

• When did the pain start?
• Is it with you all the time?
• Is it getting worse?
• How would you describe the pain?
• Is it a sharp or stabbing pain?
• Or is it a pulling or grabbing?
• Does it feel like a bruise?
• Is it a crushing pain?
• Does it feel like pressure or heaviness? (This may be a sign of (angina or heart attack)
• Exactly where is the pain?
• Is it only on one side?
• Is it the same on both sides?
• Is the pain worse with bending or twisting?
• Is it worse with coughing?
• Is it worse with a deep breath?
• Has there been a chest injury?
• What other symptoms are also present?

Diagnostic tests performed include the following:

• Chest x-ray
• Chest CT and/or MRI

Laboratory studies will also be helpful in many cases.

Get more information about rib pain and related topics as well as...

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• Ignored remedies that eliminate fibromyalgia symptoms quickly!

• Obsolete treatments for knee osteoarthritis that still are used... and may still work for you!

• The stiff penalties you face if you ignore this type of hip pain...

• 7 easy-to-implement neck pain remedies that work like a charm!

• And much more...

Click here Second Opinion Arthritis Treatment Kit

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