<s>[INST] Left sided lower rib cage anterior pain. No known injury other than possibly brought on by raking the yard. Pain is sudden and sharp with a stabbing sensation. Pain is intermittent. Pain scale = 4/10 to 5/10. Increased pain with coughing or sneezing. No history of cardiac and no other related cardiac symptoms. Wife a nurse at JHH and thinks possible costochondritis or possibly related to my Rheumatoid arthritis. No fever. No nausea or vomiting. No diarrhea. Feels better after taking Motrin. What do you think this may be? [/INST] Hello Thanks for writing to us, I have studied your case with diligence.As per your history there is possibility of rib contusion or costochondritis.Rib contusion is visible on X ray . I will advise to consult to orthopaedic surgeon.Medication like muscle relaxant and analgesic will reduce pain along with it use rib support belt.You may consult physiotherapist for pain management. He may start TENS, or ultrasound which is helpful in your case.Hope this answers your query. If you have additional questions or follow up queries then please do not hesitate in writing to us. I will be happy to answer your queries. If you find this answer helpful do not forget to give rating at end of discussion.Wishing you good health.Take care </s>