A young lady is presented with a severe chest pain. Her ECG and cardiac enzyme ruled out a cardiac origin (or partly). It was localised to 5th intercostal space next to left sternal edge. To tell the truth, the specialists, the MOs and HO have no clue. Her chest-xray shows no abnormalities.  So, the diagnosis is costochondritis. She was discharged with analgesic as the pain had partly resolved.

I just wonder if there anything that can be done for her. I order an outpatient echo and follow-up at clinic. I hope the additional investigation can safely rule out any cardiac origin and may hope the clinic can picked something.

In medicine, if the diagnosis is unclear, all the management may be futile and it’s harmful to patient. It’s causes treating a non-exist disease and delay treatment of a real disease.

Just the other day, a lady with high grade fever present with LIF pain. It’s should be a acute pyelonephritis. Surprisingly, urine test negative. At the same time, she having cough. So finally x-ray of chest was ordered. True enough, a haziness appear at the lower zone of left lung.  Anyway, she already given antibiotics and it’s seem working well, the pain went away.