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The upper rib bones, sternum and breastbone are connected to each other with the help of a cartilage. Inflammation of this cartilage is called costochondritis.

This condition causes localized tenderness and chest wall pain. It may feel like stabbing pain under the rib cage and is strongly associated with breathing difficulties. Pain and tenderness associated with costochondritis typically worsens with coughing, taking deep breaths, or moving your trunk. Patients usually begin to take quick short breaths to compensate for the pain.

This condition can develop as a result of trauma, injury, physical strain (lifting heavy objects), arthritis, or joint infections. People between 20 and 40 years of age are more likely to develop costochondritis. It is considered the most common cause of musculoskeletal chest pain.

There are some other conditions that have similar symptoms. The pain under your rib cage on the right side could be due to a pulled muscle or a back injury. If you take a look at human anatomy, the organs located on the right side, below rib cage are the liver, gall bladder, and a portion of the large intestine.

Pain under the rib cage on the right side is referred to as right upper quadrant (RUQ) pain in medical terminology. Any kind of damage to the liver, inflammation of the liver, or infection can result in pain under the right rib cage. Liver diseases such as hepatitis, fatty liver, and liver cirrhosis, tend to cause pain in this region.

Gall bladder diseases, too, may cause pain in upper right quadrant which may be experienced as pain under the rib cage. These diseases occur mostly due gallstones, and more rarely due to an inflammation of the gallbladder. Besides that, people with Crohn's disease (inflammatory bowel disease), irritable bowel syndrome, and ulcers may experience severe pain in right upper abdomen. This is also true for those who overeat.

Taking into consideration the given symptoms, the most probable cause of pain below the right rib cage is costochondritis. This is because none of the diseases given above, except costochondritis, have any association with difficulty in breathing or increase in pain with movement.

Pain that occurs due to costochondritis usually subsides spontaneously and does not need any medical intervention. However, if you are experiencing this pain frequently, you should see your doctor.

The following lab tests will help you rule out the other medical conditions:

  • Complete blood count (CBC)

  • Liver function tests (LFTs)

  • Renal function tests (RFTs)

  • ECG

If these tests are normal, your pain is most likely due to costochondritis. Costochondritis treatment is symptomatic. Anti-inflammatory drugs are prescribed to reduce the pain.

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