II. Evaluation

III. Differential Diagnosis

  1. See Chest Pain
  2. Muscle Strain (overuse syndrome)
    1. Superior: Trapezius Insertion
    2. Mid: Pectoralis Muscle
    3. Inferior: Latisimus dorsi insertion
  3. Costochondritis
    1. Common, costochondral margin pain typically at several sites without swelling or induration
  4. Tietze Syndrome
    1. Rare, focal costochondral margin pain with localized swelling and inflammation
    2. Inflammation secondary to localized infection, neoplasm or Rheumatologic Condition
  5. Slipping Rib Syndrome
    1. Hypermobile, tender anterior portions of inferior costal cartilage
    2. "Hooking maneuver" reproduces pain (and in some cases a click)
      1. Hook fingers under lower ribs and pull anteriorly
  6. Fibromyalgia
    1. Chest Tender Points at second costochondral margin (in addition to 10 total of 18 points positive)
  7. Thoracic Herpes Zoster (Shingles) or Postherpetic Neuralgia
    1. Unilateral, dermatomal distribution of clustered vessicles on a red base
  8. Painful Xiphoid Syndrome
    1. Localized tenderness over the sternoxiphoid joint
  9. Arthritis
    1. May affect sternoclavicular joint or sternomanubrial joint
  10. Mastalgia (Breast Pain)
    1. See Mastalgia
  11. Pathologic Destruction of Costal Cartilage (by infection or cancer)
    1. Infection (Bacterial or fungal) or cancerous lesions may cause local destruction of costal cartilage
    2. Infections are higher risk in post-op state, as well as in intravenous drug use

IV. Precautions

  1. See Chest Pain
  2. Heart disease can coexist with Chest Wall Pain

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Related Studies

Ontology: Chest wall pain (C0008035)

Definition (NCI) Painful sensation in the chest wall region.
Definition (NCI_CTCAE) A disorder characterized by marked discomfort sensation in the chest wall region.
Concepts Sign or Symptom (T184)
SnomedCT 366958004, 367183005, 102588006
Dutch borstkaswandpijn
French Douleur thoracique pariétale
German Brustwandschmerz
Italian Dolore della parete toracica
Portuguese Dor na parede torácica
Spanish Dolor de la pared torácica, dolor de la pared torácica (hallazgo), dolor de la pared torácica
Japanese 胸壁痛, キョウヘキツウ
English Chest wall pain, chest pain localizing to chest wall, chest pain localizing to chest wall (symptom), chest pain localizing to the chest wall, Chest Wall Pain, chest wall pain, chest pains wall, wall chest pain, chest pain wall, pain chest wall, Chest wall pain (finding)
Czech Bolest hrudní stěny
Hungarian Mellkasfali fájdalom

Ontology: Chest wall tenderness (C0239008)

Concepts Finding (T033)
SnomedCT 102591006, 162425003
English CHEST TENDERNESS OF, Tenderness of chest, chest palpation tenderness muscle, thoracic muscle tenderness, chest tenderness, Chest wall tenderness, tenderness on palpation of chest, tenderness on palpation of chest (physical finding), tenderness on palpation of chest wall muscle (physical finding), tenderness on palpation of chest wall muscle, chest tenderness wall, Chest wall tenderness (finding), Chest tenderness, Chest tenderness of
Spanish dolor de la pared torácica a la palpación (hallazgo), dolor de la pared torácica a la palpación, Dolor a la palpación torácica, sensibilidad en el pecho (hallazgo), sensibilidad en el pecho, PECHO, DOLOR A LA PRESION
Dutch gevoelige borstkas
French Endolorissement de la poitrine, Sensibilité thoracique, OPPRESSION THORACIQUE
German Druckschmerz Thorax, Brust, Empfindlichkeit, BRUSTKORB EMPFINDLICH
Italian Dolorabilità toracica
Portuguese Hipersensibilidade dolorosa do tórax, SENSIBILIDADE TORAXICA
Japanese 胸部圧痛, キョウブアッツウ
Czech Zvýšená citlivost hrudníku
Hungarian Mellkas érzékenysége, Mellkasi érzékenység