Question: I have had a pain in the ribs on my lower right side on and off for at least a year. My doctor doesn't know what causes the pain. What could it be?
Dr. Hibberd's Answer:
Local rib pain should be distinguished from the referred pain from a nerve or spinal disorder. Once the affected area is identified, appropriate imaging, such as CAT scan, which uses X-ray slices, or MRI (nuclear magnetic resonance) would seem appropriate. PET (positron emission tomography) scans are used to identify malignant disease.
Persistent pain in the chest wall not associated with obvious evidence of underlying disorder or injury definitely deserves aggressive evaluation.
Although pain localized to the area where ribs and cartilage meet may be from costochondritis (a benign self-limited condition), an examination is important to discriminate from other conditions that may need more immediate attention.
Malignancy must be excluded, especially given the extended period you have had it. One point in your favor is that it is not continuous; pain from malignancy is usually continuous.
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