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Slight pain and tenderness in rib. Should I go for diagnosis?

Jan 2013
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Answered by

Internal Medicine Specialist
Practicing since : 2003
Answered : 1658 Questions
Hi Doctor,
my problem is that im having tenderness over the second rib from last 2 months or such there is no pain but wen i press my 2nd rib near the manubrium there is tenderness n also there is slight pain over that region in XXXXXXX inspiration.should i get any investigation done.what can be the diagnosis?
Posted Sun, 10 Mar 2013 in Bones, Muscles and Joints
Answered by Dr. Mayank Bhargava 39 minutes later
Welcome to XXXXXXX forum.

Let me know the associated symptoms along with pain.
Do you have fever/ cough along with sputum / respiratory distress?
Do you have past history of any injury?
Do you have any associated lung tissue involvement along with TB lymphadenitis 2 years back?
Do you have any chest deformity such as angled ribs (found in rickets)?

With the available described symptoms, there appears to be possibility of costochondritis (inflammation at joint of bone and cartilage) at second ribs junction, hyperalgesia (increased pain sensation in skin at affected area).
Possibility of involvement of pleura should also be kept in mind as pain is getting worse on inspiration.
There could also be possibility of recurrent pressure induced joint injury by causing surface damage of articulating surfaces (bone and cartilage).

Although aggravation of pain with XXXXXXX inspiration suggestprobable involvement of muscles but localized involvement of muscle appears to be least.
Other possibilities could be deficiency of 1, 25 dihydroxy cholecalciferol, serum calcium, but these are also associated with generalized body ache.

You should consult with XXXXXXX medicine specialist and should go for thorough check up.
You should also go for chest x XXXXXXX serum calcium, serum 1, 25 dihydroxy Vit D3 level.
Any possibility of involvement of lung tissue and pleura could be detected by simple chest x XXXXXXX
Avoid putting pressure on at pressure site.

Meanwhile, you should take analgesics along with muscle relaxants.
You should apply hot soakings at second ribs joints for soothing effects.
Let me know your other queries.

Hope that helps.
Take care,
Dr. Mayank Bhargava

Above answer was peer-reviewed by
Follow-up: Slight pain and tenderness in rib. Should I go for diagnosis? 8 hours later
actually there is no other associated symptom along wid dis pain which i described. no cough, no fever and there was no involvement of the lung parenchyma when i had TB lymphadenitis 2 yrs back.there is no past history of any injury also.
Answered by Dr. Mayank Bhargava 31 minutes later
There appears to be high chances of costochondritis and hyperalgesia.
You should go for above mentioned investigations and let me know the results.
You should first take analgesics along with muscle relaxants.
If partial improvement occurs then you should go for opiod analgesics such as tramadol (effective in hyperalgesia).
Best regards,
Dr. Mayank Bhargava
Above answer was peer-reviewed by
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