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I have cronic pain last 8 years...
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I have had bilateral lower costal margin (lower rib margin) pain, flank pain for about 8 years .
Pain pattern
Pain starts within 1 second of sitting.
Standing reduces the pain by about 90% within 10 seconds.
Walking causes only 2–5% pain.
Before getting out of bed in the morning, I have no pain.
Lying down causes about 20% pain.
The pain is spread across both lower rib margins, not one small point.
The sensation is mainly pressure/tightness, not burning or stabbing.
The pain is NOT affected by
Deep breathing
Coughing
Sneezing
Meals
Leaning forward
Hard vs. soft chair
Pressing on the painful area
Tests reported as normal
CBC
ESR
CRP
Vitamin D
Vitamin B12
Urine tests
Chest X-ray
Abdominal ultrasound
Thoracic (dorsal) spine MRI
Upper GI endoscopy
Musculoskeletal ultrasound of the anterior abdominal wall
Chest wall MRI has been performed, and the report is expected today.
Treatments tried..."I have just received my chest MRI report today."
Answers (7)
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Bl pleural effusion systemic causes may be
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As it is a case of bilateral pleural effusion, systemic causes have to be ruled out. TB or other lung pathology is highly unlikely. It's mostly due to other systemic pathology and complications of that.
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it's a sequale of infection that's leading to effusion and pneumonitis, ultimately causing your pain..need proper workup to be done
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Reports suggests an sequele of infection in lungs as there is reactive pleural effusion and pleural thickening.need more detailed history (like occupation,fever,past history of illness)to know the course of illness and further work up
Next Steps
Usg guided pleural aspiration can be tried to get more clues and in ruling out some dd s like tb
Mantoux test
Sputum AFB/CBNAAT
GRAM STAIN
FUNGAL ELEMENT
PYOGENIC C/S
Health Tips
Consult a nearby pulmonologist for detailed examination and further work up
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Dr. A Raja Prasanna Kumar
Pulmonologist
46 yrs exp
Hyderabad
May be due to post infection. Pl consult pulmonologist with reports..
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Dr. Sivaraj Karri
Pulmonologist
10 yrs exp
Kakinada
Consult a pulmonologist
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Dr. Kirubanandam Arularasan
Respiratory Medicine
9 yrs exp
Thanjavur
The chest pain which u have mentioned might be due to pleural effusion. But we need to evaluate the reason of this effusion. As MRI mentioned it as bilateral pleural effusion. Systemic causes have to be ruled out too. Need to do Ultrasound of chest to look for depth of pleural effusion and if it is significant we need to do pleural tapping and need to send for analysis.
Next Steps
kindly do USG chest
ECG
ECHO
RFT
LFT
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Disclaimer : The content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding your medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this website.