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Right costal cartilage
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Right costal cartilage

Hi I was treated for Tuberculosis last year and I originally had sharp pains which disappeared with my tuberculosis treatment but I had this sharp pain in my right ribs when I tried to breathe, so I couldn’t almost breathe. One morning when I woke up I knew I had pain so refrained from even trying to take a breath, I used my nose instead to breathe. When I got up, I stretched my arms up and I took a full breath and I felt my right ribs crack in. It was like they had been pushed or pressed in, and ever since then I haven’t been able to take a full breath. When I wake up I felt the pain on a short breath. Sometimes when I try my best to take a full breath I feel the pain directly behind my ribs in my back but I suspect this is referred pain. I also experience my right upper chest tightening and the hospital say this is because I'm not taking a full breath. Last December I had a CT scan and nothing abnormal was found except this: "In the thoracoabdominal region, there is some asymmetry of costal cartilage with some concavity on the right side.this presumably may have resulted from past trauma and be giving rise to mechanical chest pain" I also had an ultrasound scan and MRI scan and there was nothing found. I was on painkillers for a long time and they weren’t helping so I stopped taking them and now they way I’m surviving is just drinking hot water and using a hot water bottle at night. Without this I can’t breathe properly. The breathing pain in my right ribs sometimes radiates to the middle and very frequently I experience a small pain in my left ribs but that is nothing compared to the great pain in my right ribs. Can this be fixed in any way? I can’t sit or stand properly because the pain is too much. I want to know if the concavity in my right side found in the scan can be fixed? I still feel this whole right side pressed in and I can’t take a full breath and at times not even half a breath. It has been One and a half years and I’m still in the same situation, stuck in the house and limited in my activities because of my pain. The orthopaedics specialist said nothing really but just inflaming of the ribs and he sent me to the pain specialist who I saw in March 2009 and he didn’t check me thoroughly and is going to give me an injection in November 2009. I also want to know if the injection is necessary for my pain. It’s very complicated but please help me. I will really appreciate it. Thanks.
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Hello Koolboi,

I am glad that you found us at the Pain Mangement Forum of MedHelp, Welcome. It am sorry to hear about your difficultly breathing due to the pain in your ribs. It sounds like all the proper tests have been preformed to diagnosis your rib pain.

I am not an expert nor a physician. In my opinion the MRI is self explanatory. You have mechanical pain due to the "concavity on the right side." I assume this refers to your rib cage and not the asymmetry of your costal cartilage. This means your rib cage  for lack of a better word, bends inward or is depressed inward. This causes you pain with inspiration. It questions previous trauma which could have occurred when you stretched and than continued with shallow breathing with promoted the concavity. Asymmetry of costal cartilage simply means there are not even when compared with your others.

I assume the injection for pain they have scheduled is a steroidal medication. These injections can help with inflammation which can be a component of your pain. In my opinion it is certainly worth a try. The area is usually injected with numbing medication (one of the caines) before the steroid is injected. Although it may be uncomfortable it should not be painful. What do you have to lose?

I do not know if there is a surgery that could help you condition. If you are interested in exploring this possibility I would request a consult with a thoracic surgeon. However this may very well mean more pain initially and you would have to force yourself to breath normally and expand your lungs regardless of the pain.

I would also be interested in knowing if PT or a Respiratory Therapist could assist you in expanding your lungs/ribs. I would discuss that possibility with your PCP or PMP.

I hope you will keep in touch and let us know how you are doing. I will be interested to hear the results of your injection and if you are able to find any other avenues to treat your painful condition. Best of luck to you.

Take Care,
Tuck
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