A 24 year old female came to the opd with the c/o of pain in the right side of chest , associated with swelling since 3-4 days.

                       GENERAL MEDICINE 
                                      ~Case based discussion
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A 24 year old female came to the opd with the c/o of pain in the right side of chest , associated with swelling since 3-4 days.   
    Apparently the patient was asymptomatic 4 days ago later she developed a sudden pain in chest and right hypochondriac region, radiating to lumbar region. It was gradual in progression , dragging type of pain and aggravated on sleeping on right side, relieved on rest.
       The pain was associated with swelling which she noticed 4 days back which was small and nodule like sudden in onset and gradual in progression which progressed to about 5 cms extending like a long linear line reaching the lumbar region.
       No history of local rise in temperature, no h/o fever, headache, vomiting, weight loss, loss of consciousness, shortness of breath, joint restriction, pain on inspiration/expiration
No known comorbidities. 
Past history: No similar complaints in the past and nothing of significance
Personal History: 
Normal appetite 
Adequate sleep
Regular bowel bladder movements 
No addictions
 On examination - 
General Examination: 
The patient is moderately built, conscious, cooperative , coherent and well aware of surrounding place and time. Consumes mixed diet.
No pallor, icterus, cyanosis, clubbing and generalized lymphadenopathy. 
Vitals : BP : 120/ 80 mm of Hg
           Pulse : 74 beats per min
           Temperature : afebrile
          Respiratory rate : 16 cpm
Systemic examination:
Chest and abdomen region:
 longitudinal linear swelling, no local rise in temperature,  
Tenderness+ 
Slip test -ve
Size : about 5cms
Axillary lymph nodes : Normal 
Breast examination: Normal
Ultrasound: Normal 
Probable Diagnosis : Mondor Diesease 
Treatment: NSAIDS

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