Question
Hi!

I抦 21, 168cm and 50kg with a huge problem that has, quite literally, popped up.

At the start of December 2008 my side started hurting and I had a lump half-way down my right side ribcage. It hurt and the pain gradually increased and became very sever in January/February and I could hardly move at all. The only thing I could do was to lie down.

I went to about 5 GPs (doctors) one told me it was nothing, just inflammation because I was going to get my period soon. The second told me it was just some inflammation with the lining between the lungs and the ribcage and to take some Ibuprofen. The third one told me it was costochondritis and that I should take Ibuprofen. Finally the 4th one told me it was rib-tip syndrome and that if it was I would have to put up with it for the rest of my life. None really said anything about the lump.

I took Ibuprofen for a month or so and it didn抰 help, then they told me to take Ibuprofen and Paracetamol, then Diclofenax and then Tramadol and then back to Ibuprofen. Nothing really helped, apart from sometimes some dulled down the pain.

One night I was sitting and turned and it felt like I had a dozen needles inside me and they just scraped along some organ or tissue inside. That抯 the best I can describe it. Like something scratched something else inside me around that area. I went to A+E because I was in agony and they took an X-ray and an ultrasound of my organs to check or gall stones or something else, but they said everything seemed ok. So they sent me to the Rheumatologist. He injected that area with some steroid injection which then made me really unwell for a week and a half. The pain increased, the area was burning and tender and hurt a lot and there was a white ring where the injection was. It hurt for 3 weeks in total. But then the pain wasn抰 a sharp stabbing pain all the time as it was before?But more of a throbbing ache. The pain would stab if I did something though.

The lump is still there?It feels as if it抯 the tip of my rib sticking out towards my skin?But it hasn抰 been explained at all. I抳e been sent to the Physiotherapist now though she doesn抰 think she can do anything apart from give me a bit more movement in my lower back which is a bit stiff.

I抦 at a loss for what to do really. It hurts when I do anything. I can抰 lie on that side and lying on my left side makes it a little uncomfortable. Whatever I do aggravates it and if I do work the popped out thing sticks out a little more. It抯 hard to move sometimes as well. The ache never goes away though, apart from in the morning when I wake up ?But when I start moving, it抯 back to say hello again.

I had meningitis and mononucleosis last year and was pushing a 39.8 degree Celsius temperature and the hospital had to give me a lot of paracetamol on drips and pills?But they gave me too much on an empty stomach and it completely threw my liver out which enlarged to double its size and made it easier for the hepatitis/jaundice to set in. The whole thing lasted for 8 months and it was with that that I noticed the lump on my side. And I had pain there then but it went away around June last year and would only kick in here and there.

I don抰 know if that抯 related or not. The doctors here didn抰 seem to think so. I had no trauma to my rib when it kicked in, in December. The only trauma it抯 ever had was 5 years ago when I severely bruised it in a fall on ice whilst skiing.

I抳e not been told of any other treatments and they don抰 want me to take anymore painkillers (neither do I) since they don抰 work too well. So what I want to know, is if there is anything else that it could be and what is there that I can do for it?

Thanks!

Answer
Without an actual hands on exam it is a little difficult to diagnose.  But, if it is rib-tip syndrome, you can try here: http://www.ejbjs.org/cgi/reprint/57/6/795.pdf  I would suggest trying a good chiropractor that also focuses on myofascial release.  He/she may be able to free things up, and allow the rib to settle back into a more normal position.