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Costochondritis

Costochondritis Facts

Costochondritis is inflammation of the junctions where the upper ribs join the costal cartilage that attaches them to the breastbone (sternum). Costochondritis causes localized chest wall pain and tenderness that can be reproduced by pushing on the involved cartilage in the front of the rib cage. Costochondritis is a relatively harmless musculoskeletal chest pain and usually resolves without treatment. The cause is usually unknown. Costochondritis affects females more often than males (70% versus 30%).

  • Costochondritis is a common cause of chest pain in children and adolescents. It accounts for 10%-30% of all chest pain in children. Annually, doctors evaluate about 650,000 cases of chest pain in young people 10-21 years of age. The peak age for the condition is 12-14 years of age.
  • Overall, costochondritis is one of the most common causes of musculoskeletal chest pain.
  • While chest pain can represent heart disease and heart attack, inflammation around the heart (pericarditis) or lungs (pleuritis), costochondritis is also considered as a possible diagnosis in adults with chest pain.
  • Tietze syndrome, or Tietze's disease, is also a cause of localized musculoskeletal chest pain. Tietze syndrome is distinguished from the more common costochondritis.
    • As opposed to costochondritis in which there is no swelling, Tietze disease is accompanied by a localized swelling at the painful area (the junction of the ribs and breastbone).

What Are Causes and Risk Factors of Costochondritis?

Costochondritis is an inflammatory process. Nevertheless, it usually has no definite cause. Repeated minor trauma to the chest wall or viral respiratory infections can cause costochondritis. Occasionally, costochondritis as a result of bacterial infections can occur in people who use recreational IV drugs or who have had surgery to their upper chest. Costochondritis can also be a feature of relapsing polychondritis, reactive arthritis, fibromyalgia, and injury.

Different types of infectious diseases can cause costochondritis, although this is uncommon.

  • Viral: Costochondritis commonly occurs with viral respiratory infections because of the inflammation of costochondral junctions from the viral infection itself or from the strain of coughing.
  • Bacterial: Costochondritis may occur after surgery and be caused by bacterial infections.
  • Fungal: Fungal infections are rare causes of costochondritis.

Costochondritis can also occur with certain forms of arthritis, such as ankylosing spondylitis and psoriatic arthritis, and is sometimes associated with breastbone pain (sternum pain) in these conditions. Costochondritis can occur in people with fibromyalgia.

Medically Reviewed by a Doctor on 8/30/2017

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Chest Pain: Is It Costochondritis?

Pain in the chest wall around the breastbone (or sternum) is the most characteristic feature of the condition known as costochondritis. Medically, the term chondritis refers to inflammation of any cartilage in the body. Costochondritis refers specifically to inflammation of the cartilage that joins the ribs to the breastbone (called costal cartilages). The chest pain of costochondritis sometimes is severe.

Costochondritis usually, but not always, involves one side of the breastbone. Sometimes the pain can extend to the shoulder or arm on the involved side. When costochondritis is accompanied by swelling of the areas surrounding the cartilage, the condition is called Tietze syndrome. In Tietze syndrome, the swollen area of the inflamed cartilage may be tender to the touch, and the skin overlying the cartilage may be reddened.


Read What Your Physician is Reading on Medscape

Costochondritis »

In contrast to myocardial ischemia or infarction, costochondritis is a benign cause of chest pain and is an important consideration in the differential diagnosis.

Read More on Medscape Reference »


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