What Pain In Lung And Under The Arm And Shoulder Blades?

Posted on Wed, 2 Jul 2014

Question: Hello. I am a 23 year old female, 5'2", 115 lbs. I take synthroid for hypothyroidism and xanax for anxiety as needed. For the past two years I have been unemployed, looking for work and my hobbies are writing and art, which means I lead a very sedentary lifestyle. For the past two months I have been experiencing random sharp pains in what seems to be my right lung and sometimes my left one, just under the arm, sometimes under the breast, sometimes right next to the shoulder blades. I don't have terrible shortness of breath, just sometimes. There is no cough, but I have also been having some leg pain that my doctors have assured me is nerve related. There is no swelling, no discoloration and it doesn't particularly hurt to walk on. It just hurts whenever it wants to. A month ago I went to ER and they did an ultrasound of my leg veins, a dye-contrast CT scan of my chest, x-ray, bloodwork, EKG and urine sample. They told me I had pleurisy. Was put on anti-inflammatories, then when the pain didn't subside they now have me on a Pulmicort inhaler, twice daily, but the sharp pains still randomly occur. I'm not convinced it's pleurisy since I don't always have pain upon breathing. Could the ER have missed small clots in the lung? They couldn't tell me what caused the pleurisy, can it really just happen for no reason?

Answered by Dr. Shafi Ullah Khan (1 hour later)

Brief Answer:
Need management, misdiagnosed

Detailed Answer:
Thank you for asking!
I understand your concern for the pains and you are right. I myself am not convinced that it is pleurisy. it seems to me a galbladder pain, rib pains, shoulder pain, deep breaths associated pain, 23 young age, hypothyroidism, sedentary lifestyle all poin to the gall bladder infection.To sort it out a simple ultrasound and blood work up for pancreatic and liver profile would have confirmed. Get to a general surgeon and let them take care of it with a simple minimal invasive cholecystectomy. It might be a pleurisy too but pain not subsiding makes it more likely a misdiagnosis and my money is on gallbladder. There was no need of CT chest and that too XXXXXXX contrast, useless work up could have been replaced with a little focus on gall bladder with a simple abdominal ultrasound and some hepatobiliary profile assessment and things would have been different.
I hope it helps. Seek a hepatobiliary surgeon and let them take care of it. Take good care of yourself and dont forget to close the discussion please.
May the odds be ever in your favour.
Regards
S Khan

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Shafi Ullah Khan (7 minutes later)

What about the leg pain? I have had sciatic pain in the past, but it's never lasted months on end like this. I went to an ortho for a ganglion cyst on my wrist and he felt my leg and said my hamstrings were tight- not sure if that has anything to do with anything.

Answered by Dr. Shafi Ullah Khan (4 minutes later)

Brief Answer:
sparate entity, need rheumatologist

Detailed Answer:
Thank you for getting back to me!
The leg pain is the recurrence of sciatic pain as other possibilities have been ruled out by leg sonographies and doppler studies. Ganglionic cyst in innocuous and has nothing to do with it. It is a separate entity and needs physiotherapy exercise, analgesics, exercises and if need be epidural steroid injections and full work up to localise the compression of the sciatic nerve from disc slipping to sciatic notch compression. Stay in touch with your orthopaedist or a rheumatologist. Remember such pains neither come in a day nor goes in one. It is slow and steady process.
precautions and full care is the key and it will subside slowly.
Seek your rheumatologist and discuss what options are good for you.
Take care

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar