Other accompanying symptoms

The occurrence of other symptoms in addition to the pain at the costal arch caused by coughing is dependent on what ultimately triggers the pain. If the pain is provoked by complaints in the colon, those affected often suffer from poor digestion and have the feeling of having an extremely bloated abdomen. Sometimes a loss of appetite is also reported.

If the focus is not on intestinal complaints, but the pain when coughing under the right costal arch is due to complaints with the gall bladder, those affected rather complain of nausea and sometimes even have to vomit. In addition, feverish conditions with accompanying chills can occur. In the case of an enlarged liver, a feeling of fullness is also reported.

If pneumonia is present, the pain of coughing is not the only symptom. Those affected often feel flabby, exhausted and less able to cope with stress than usual. In pneumonia, the cough can also be productive but also dry. Patients with an inflammation of the pleura (Latin pleuritis) show a similar symptom.They also have fever and pain when coughing, which is dry. A pulmonary embolism, on the other hand, leads to shortness of breath and a tightness in the chest in addition to chest pain and a dry cough.

Diagnosis

The diagnosis is based on an initial suspected diagnosis by the treating physician. In any case, a detailed anamnesis and a physical examination are the first priority. At this stage, the attending physician can already obtain some essential information that can be used as a guideline for further diagnostics.

Only by auscultation and percussion of the lungs, i.e. listening and tapping, can a distinction be made as to which disease may be involved that causes increased pain in the costal arch when coughing. If one suspects that abdominal organs may be the trigger for the pain, an enlarged liver on the left or an enlarged spleen on the right side can be palpated, for example. Subsequently, further diagnostic measures can be taken.

Ultrasound examination is suitable for the first time to assess certain organs more closely. In addition, an x-ray of the thorax can be useful if bony lesions are suspected. An MRI or CT scan is only necessary in rare cases that are difficult to diagnose. However, a detailed diagnosis is generally very important in order to detect or exclude all other concomitant diseases or differential diagnoses and to treat them accordingly.