<unk>  is predominately a clinical diagnosis only after life-threatening conditions have been ruled out, with physical examination and medical history being considered. Before a<unk>  diagnosis is made, other serious causes of chest pain are investigated. Further evaluation for cardiopulmonary or neoplastic causes is typically based on history, age, and risk factors, with diagnostic imaging and tests, completed to assess for life-threatening emergencies. If there is a suspicion of infection or a rheumatoid condition, laboratory work may be conducted. A physical exam will assess for tenderness or pain upon palpation, with an absence of heat, erythema, or swelling. The physical exam may assess if the pain is worsened with movements of the upper body or breathing, and may be reproduced upon using the crowing rooster maneuver, the hooking maneuver, or the horizontal flexion maneuver. Medical history is considered in diagnosing<unk> , such as inquiry regarding any recent trauma, coughing, exercise, or activity involving the upper body that may have caused the symptoms. Differential diagnosis Cardiopulmonary Life-threatening medical emergencies that may be associated with chest wall pain include acute coronary syndrome, aortic dissection, pneumothorax, or pulmonary embolism. Other cardiopulmonary causes of chest pain similar to that produced by<unk>  may include but are not limited to myocardial infarction, angina, and pericarditis. With<unk> , the pain is typically worse with respiration, with movement, or within certain positions. Typically with other causes of chest pain, individuals will likely have radiating pain, shortness of breath, fever, a productive cough, nausea, dizziness, tachycardia, or hypotension. These conditions will be ruled out using tests such as X-rays, which will help assess for pneumonia, pneumothorax, lung mass, and other concerns. Other tests such as an electrocardiogram (ECG) can be performed to exclude infection, ischemia, and other conditions. A laboratory workup can rule out acute coronary syndrome, pulmonary embolism, and pneumonia.<unk>  will yield normal results for these tests. right Musculoskeletal There are several musculoskeletal conditions similar to<unk>  that are often confused. One such condition includes Tietze syndrome, which is often confused with<unk>  due to the similarity in location and symptomatology. Typically,<unk>  is a more common condition that is not associated with any swelling, affects multiple joints (usually of the 2nd to 5th ribs), and is usually seen in individuals older than 40 years of age. Tietze syndrome is a rarer condition that usually has visible swelling, commonly affecting a single joint (usually of the 2nd or 3rd rib), and typically seen in individuals younger than 40 years of age. A similar condition known as slipping rib syndrome is also associated with chest pain and inflammation of the costal cartilage. Unlike<unk> , the pain associated with slipping rib syndrome is often felt in the lower ribs, abdomen, and back, commonly affecting the interchondral junctions of the false 8th to 10th ribs.<unk>  is typically experienced within the sternocostal junctions of the true 2nd to 5th ribs. Other musculoskeletal conditions that may cause chest pain similar to<unk>  includes but are not limited to, painful xiphoid syndrome, muscle strain, myofascial pain syndrome, thoracic disk herniation, and rib fracture. Other * Rheumatologic conditions such as fibromyalgia, SAPHO syndrome, ankylosing spondylitis, rheumatoid arthritis, and psoriatic arthritis can cause symptoms similar to<unk> . * Oncology-related conditions, namely neoplasms and myelomatous pleural effusion have been associated with chest pain. * Chest pain is occasionally experienced with respiratory-related conditions such as pleuritis, precordial catch syndrome, and pneumonia. * Psychogenic conditions such as anxiety disorders, panic disorders, and hyperventilation syndrome may cause chest pain. * Some gastroenterology conditions may be associated with<unk> -like chest pain such as gastroesophageal reflux disease, and esophagitis. *Viral infections such as herpes zoster and Bornholm disease are seen as differential diagnoses for<unk>  due to chest pain being a reported symptom. *Vitamin D deficiency can be a differential diagnosis for<unk>  as it may cause chest pain. *Chest pain has also been reported following the use of cocaine, which can increase the risk of various cardiovascular conditions.
Costochondritis
Pneumothorax
Osteochondritis
Pulmonary embolism
Athletic pubalgia
Fibromyalgia
Epicondylitis
Angina