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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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What Causes Right Sided Rib Pain For An Ewing Sarcoma Remission Patient?

Hello , I am a 2 year Ewing sarcoma remission patient . I am 19 years old and my recent blood results have revealed that my bilirubin has been increasing in the past six months . It is about 1.6 now. I often get a sharp pain on my right side and it penetrates deep into my 5th/6th rib. Should I be concerned ? My pediatric oncologist thinks it may just be a liver infection.
Mon, 1 Dec 2014
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Internal Medicine Specialist,  's  Response
Further evaluation is needed. "Just" a liver infection is not an acceptable answer. Any type of liver infection could be serious. What kind of liver infection? Is it acute hepatitis? Is the bilirubin increasing because of a blockage in the liver, such as gallstones? Bilirubin can also rise from red blood cells breaking down (hemolysis), which can occur from medicine and different types of allergic-like reactions. Also, I would want to know why you are having rib pain. Maybe a scan is necessary to diagnose it. Could you be having a relapse of the Ewing sarcoma? These are questions that should be answered promptly. Hope this helps.
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General & Family Physician,  Dr. Chobufo Ditah's  Response
Hi,

I am so sorry to hear about this pain that you have reported. With rising bilirubin levels, the chances are higher that this is most likely from the liver. What the exact cause is cannot be determined without a complete physical exam and maybe some testing. I will suggest that you follow up with your doctor for a more comprehensive testing and diagnosis so that management can be tailored accordingly.


I hope this helps. I wish you well. Thank you so much for using our services and feel free to ask for more information and clarifications if need be.
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What Causes Right Sided Rib Pain For An Ewing Sarcoma Remission Patient?

Further evaluation is needed. Just a liver infection is not an acceptable answer. Any type of liver infection could be serious. What kind of liver infection? Is it acute hepatitis? Is the bilirubin increasing because of a blockage in the liver, such as gallstones? Bilirubin can also rise from red blood cells breaking down (hemolysis), which can occur from medicine and different types of allergic-like reactions. Also, I would want to know why you are having rib pain. Maybe a scan is necessary to diagnose it. Could you be having a relapse of the Ewing sarcoma? These are questions that should be answered promptly. Hope this helps.