[18F] With sharp right-sided rib pain and radiating back pain

Patient Description

An 18-year-old female has been experiencing sharp pain on the right side of her lower ribs for about two weeks, particularly severe when lying on her right side, rated as 7 out of 10. The pain radiates to her shoulder and lower back. She also reports slight back pain on the right side. There have been no recent injuries, fever, chills, changes in bowel movements, urinary symptoms, or yellowing of the skin or eyes. The patient has a history of Polycystic Ovary Syndrome (PCOS) diagnosed in 2019 and frequent urinary tract infections (UTIs) since 2011. She has had past pregnancies and is allergic to birth control. She is not currently taking any medications. The patient has used recreational drugs, alcohol, or tobacco products recently.

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Arora's Assessment

What might be happening

Based on the information you have provided, here are some possible explanations for your symptoms:

  • Musculoskeletal Pain: This could be due to muscle strain or inflammation of the muscles and tissues around your ribs and back. This type of pain is often sharp and can worsen with certain movements or positions, such as lying on your side.

    • Treatment: Over-the-counter pain relievers like ibuprofen or acetaminophen, rest, and avoiding activities that worsen the pain can help. Applying heat or cold packs to the affected area may also provide relief.
  • Costochondritis: This is an inflammation of the cartilage that connects a rib to the breastbone. The pain associated with costochondritis can be sharp and is often worsened by certain positions or physical activities.

    • Treatment: Similar to musculoskeletal pain, treatment includes pain relievers, rest, and avoiding activities that exacerbate the pain.
  • Kidney Issues: Pain radiating to the back and shoulder could indicate a kidney problem, such as a kidney stone or infection. Given your history of frequent UTIs, this is a possibility.

    • Treatment: It's important to see a healthcare provider for a proper diagnosis. They may recommend imaging tests like an ultrasound or CT scan and possibly prescribe antibiotics if an infection is present.
  • Gallbladder Issues: Pain that radiates to the shoulder and back can sometimes be related to gallbladder problems, such as gallstones.

    • Treatment: This requires medical evaluation and may involve imaging tests to diagnose. Treatment could range from dietary changes to surgical intervention.

What you can do

  1. Rest and Avoid Aggravating Activities: Try to rest and avoid activities that worsen your pain, such as lying on your right side.
  2. Over-the-Counter Pain Relief: Consider taking over-the-counter pain medications like ibuprofen or acetaminophen to help manage the pain.
  3. Hydration and Diet: Ensure you stay well-hydrated and maintain a balanced diet. If you suspect gallbladder issues, try to avoid fatty foods.
  4. Heat or Cold Therapy: Applying a heating pad or cold pack to the affected area may provide some relief.

What you should look out for

Seek medical attention if you experience any of the following:

  • Severe or Worsening Pain: If your pain becomes more severe or does not improve with over-the-counter medications and rest.
  • Fever or Chills: These could indicate an infection that needs prompt medical attention.
  • Changes in Urination: Painful urination, blood in the urine, or changes in the frequency or urgency of urination could indicate a kidney issue.
  • Yellowing of Skin or Eyes: This could be a sign of a liver or gallbladder problem.

Remember, this information is not a substitute for professional medical advice. Please consult a healthcare provider for a formal diagnosis and appropriate treatment.

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6 mo ago


People Also Ask


What are the common causes of sharp pain on the right side of the lower ribs?

Common causes of sharp pain on the right side of the lower ribs include musculoskeletal pain, costochondritis, kidney issues, and gallbladder problems. Each of these conditions can cause pain that may radiate to other areas such as the shoulder or back.


How can musculoskeletal pain be managed at home?

Musculoskeletal pain can often be managed at home with over-the-counter pain relievers like ibuprofen or acetaminophen, rest, and avoiding activities that worsen the pain. Applying heat or cold packs to the affected area may also provide relief.


What symptoms indicate a possible kidney issue?

Symptoms that may indicate a kidney issue include pain radiating to the back and shoulder, changes in urination such as painful urination, blood in the urine, or changes in frequency or urgency of urination. Given a history of frequent UTIs, these symptoms should be evaluated by a healthcare provider.


When should I seek medical attention for rib pain?

You should seek medical attention for rib pain if it becomes severe or does not improve with over-the-counter medications and rest, if you experience fever or chills, changes in urination, or yellowing of the skin or eyes, as these could indicate more serious underlying conditions.


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