A 20-Year-Old With Anterior Chest Pain: Rare Diagnosis Behind a Common Concern

A 20-year-old previously healthy man presented to our hospital with a 2-week history of dull aching pain localized to the anterior chest wall, specifically in the sternum region. The pain was non-radiating and was exacerbated by physical activity or deep inspiration. There was no associated swelling, redness, or deformity of the chest wall. There were no associated systemic symptoms such as fever, weight loss, night sweats, and fatigue. Additionally, there was no history of recent respiratory infections, coughing, wheezing, dyspnea, hemoptysis, palpitations, edema, or orthopnea to suggest pulmonary or cardiac involvement. The patient was of Indian ethnicity and has been living in India since birth. However, he had no known exposure to individuals with active pulmonary TB. The patient reported no history of trauma, repetitive physical strain, or prior surgical interventions, such as sternotomy or chest wall procedures. His medical history was unremarkable, with no prior hospitalizations or chronic illnesses. There was no personal or family history of autoimmune disorders, such as ankylosing spondylitis, rheumatoid arthritis, or psoriatic arthritis, and he specifically denied symptoms such as morning stiffness, joint swelling, or peripheral joint pain that might suggest an inflammatory or autoimmune disorder. The absence of gastrointestinal or urogenital symptoms further reduced the likelihood of reactive arthritis or other systemic conditions. Relevant negatives also included no history of smoking, immunosuppressive therapy, or conditions such as diabetes or HIV that could increase susceptibility to infections.