I've got a 93 CC W-250 w/ 190,000 miles and a 91. 5 W-350 w/147,000. Both have the Getrag five speeds and 4. 10 limited slip rears. When backing there is a grinding sound in the rear of the truck and a loud thump that shakes the truck when turning left while backing. It will do it sometimes when unloaded but mainly when gooseneck is hooked up. I've tried to duplicate the noise when I'm listening, but no luck. Pulled diff covers and all is intact in the rearend.
Must be a Dodge thing. I've had several Dodge's over the years and when they break they seem to self repair if you keep driving 

