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Suggest Treatment For Swelling In The Rib Cage

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Posted on Tue, 17 Mar 2015
Question: I'm having swelling in my rib cage/chest area. Bras are too tight to wear for longer than an hour or two. Even softer, stretchy versions (ie a sports bra) become uncomfortable and leave deep indentions. Some of these I wore after pregnancy when I was 40 pounds heavier and breast feeding. They were fine then, tight now. There seems to be some swelling in my wrists and hands as well. Possible abdomen as well. What could be causing this?
doctor
Answered by Dr. Shoaib Khan (1 hour later)
Brief Answer:
?? Suspecting an orthopaedic issue for now ma'am, needs confirmation

Detailed Answer:
Hello ma'am and welcome.

Thank you for writing to us.

I have gone through your query with diligence and would like you to know that I am here to help. From the provided information you mean to say that your ribcage region seems to be swollen up, but no general increase in the size of your breasts?

If so, this along with swelling in your wrists and hands could indicate an orthopaedic issue (e.g. arthritis). I would of course have preferred to physically examine the swollen regions myself if I were your doctor, but as I cannot I would recommend a visit to an orthopaedic doctor. Along with a physical examination I would order a few blood investigations like:

+Comprehensive blood panel
+ESR
+RA factor
+CRP
+X ray examination of your wrist region

I am also suspecting your presentation to be a gradual development, and not a sudden appearance of symptoms? Please do write back to me with this information as well ma'am, thank you so much. At present, there is nothing serious you should be worried about, but it would be best to evaluate you, and if at all required initiate treatment to help make you feel more comfortable.

Best wishes.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Shoaib Khan (29 hours later)
Yes, there is an increase in the chest, shoulder, ribcage areas but not the breasts. This has been gradual, not sudden, since around Christmas. It has gotten unbearable though on a daily basis. When I wear anything constricting in the area I start to feel pain in the abdomen and start coughing. I don't really feel short of breath, but a kind of dry cough and a feeling of swelling on the right side of my throat. This also happens when I run. After about a mile I begin to feel the swelling in the throat, feel like its hard to swallow and clear my throat, and begin the dry cough. Also, I am feeling fatigued. I'm a stay at home mom with a teenager and two toddlers, so I'm always tired.....but lately seems much more. I have enlarged lymph nodes in the neck (since last June). These have been looked at, I only mention them to give you the facts. I also have some abdominal tenderness, directly below the sternum and at the bottom of the right rib cage. I was told by one doctor last summer that there was a cyst, but nothing to worry about. My RA factor was negative in August. My last CBC was in early January, it included platelets and a full Thyroid panel. The doctor included platelets because of broken blood vessels on the chest and neck, what he called "spiders". All was normal except a slightly low testosterone level. I'm nearly 35 and have been happy, healthy, and active my whole life. I refuse to think that I feel bad now just because I'm aging! I've never been one to "look" for problems....I'm just really looking so hard now to find an answer so I can fix it and feel better! I'm trying to figure out which way to proceed with my current doctor or which type of new doctor to seek out. Your help is appreciated.
doctor
Answered by Dr. Shoaib Khan (6 hours later)
Brief Answer:
Have a few suggestions ma'am, nothing specific for now unfortunately

Detailed Answer:
hello once again ma'am.

Thank you so much for the detailed response.

I must say your query is indeed a slightly mixed and confusing one, but let us see what we can work towards together.

First of all, the lethargy can be caused by many issues (especially in mid-aged women) anaemia and vitamin D (and calcium) levels have been found to be the most common factors. I would thus recommend a check on your:
+Hemoglobin
+Vitamin D
+Serum calcium
+Sex hormone levels
+X ray chest
+X ray of your wrist
+Blood coagulation profile
+Lipid profile (to be conducted early in the morning on an empty stomach)

You are still young, and 35 years should not necessarily be suspected for approaching menopause, but it would still help to check your sex hormone levels as they can play a major role in your presentation, if found to be imbalance.

I would also like to advise weight loss if at all you have put on weight off-late, please do write to me with your height and weight so I can calculate your BMI and advise accordingly. I understand that my list of suggestions is a little elaborate, but you must understand that for now we only have very unclear hints as to what the problem could be. And only more information (hopefully) provided by your laboratory analysis will help in guiding us with a way forward.

Please do not lose heart, eat healthy, exercise everyday, sun exposure, and a health mind set will take you a long way.

Best wishes.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Shoaib Khan (3 days later)
Yes, sorry. Sometimes I digress and worry that maybe some little piece will solve the puzzle. My main concern/question is the swelling of the chest. I have had some pain also. And not sure if this is related or not, but I flew home from a short trip a day ago. As the airplane climbed I felt pressure and a tightening in my chest. It was painful. I had some pain pretty consistent for the next 24 or so hours. Now it's back to every now and then. As for weight I haven't gained recently, except the occasional few over the holidays. I'm am 5'5" and weigh around 125 (give or take a few pounds on a daily basis). Do you still think orthopeadic is my best route to pursue? Thanks for your input.
doctor
Answered by Dr. Shoaib Khan (13 minutes later)
Brief Answer:
An orthopedic consult should hopefully prove fruitful

Detailed Answer:
Hello once again ma'am.

Thank you once again for that information.

I would like to add another possibility to our list of considerations, it is a condition called costochondritis. Costochondritis is the inflammation of the cartilage that connects the ribs to the breast bone. Although the pain with costochondritis is centralized and mainly in the central region of the chest, the pain still could appear in other regions of the rib cage as well.

I would also like to put forward a request to attach images of the region in speaking, if you do not mind doing this. I am not sure what I may visualize and how it may help, but a physical examination is always considered fruitful. If you are not comfortable with this, then I would surely understand. But if at all you are in agreement ma'am, then please try to attach clear images of the region in speaking from all angles, including the back.

You can do so by simply attaching images of the affected region to our discussion, or send the images to:

YYYY@YYYY

and do mention "ATTN: Dr. Shoaib Khan" in the subject line.

Please do schedule an appointment with an orthopedic either way.

Best wishes ma'am.
Note: For further queries, consult a joint and bone specialist, an Orthopaedic surgeon. Book a Call now.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Answered by
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Dr. Shoaib Khan

General & Family Physician

Practicing since :2009

Answered : 9409 Questions

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Suggest Treatment For Swelling In The Rib Cage

Brief Answer: ?? Suspecting an orthopaedic issue for now ma'am, needs confirmation Detailed Answer: Hello ma'am and welcome. Thank you for writing to us. I have gone through your query with diligence and would like you to know that I am here to help. From the provided information you mean to say that your ribcage region seems to be swollen up, but no general increase in the size of your breasts? If so, this along with swelling in your wrists and hands could indicate an orthopaedic issue (e.g. arthritis). I would of course have preferred to physically examine the swollen regions myself if I were your doctor, but as I cannot I would recommend a visit to an orthopaedic doctor. Along with a physical examination I would order a few blood investigations like: +Comprehensive blood panel +ESR +RA factor +CRP +X ray examination of your wrist region I am also suspecting your presentation to be a gradual development, and not a sudden appearance of symptoms? Please do write back to me with this information as well ma'am, thank you so much. At present, there is nothing serious you should be worried about, but it would be best to evaluate you, and if at all required initiate treatment to help make you feel more comfortable. Best wishes.