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Symptoms and Signs of Costochondritis

Doctor's Notes on Costochondritis

Costochondritis is a common condition that is characterized by inflammation of the cartilage in the chest at the point where the ribs attach to the breastbone (the sternum). It usually occurs on one side of the chest only. The inflammation causes pain in the front of the chest. When swelling of the area is also present, the condition is referred to as Tietze syndrome. The cause of costochondritis is not well understood. Viral infections, trauma, and hereditary factors (genetics) may all play a role in its development.

Costochondritis can occur on its own or may be part of another, more widespread, condition such as fibromyalgia, rheumatoid arthritis, ankylosing spondylitis, lupus, or inflammatory bowel disease. Associated symptoms include chest discomfort that may manifest as sharp pain, pressure, or an aching pain in the front of the chest near the breastbone.

Medical Author:
Medically Reviewed on 3/11/2019

Costochondritis Symptoms

  • The reproducible tenderness when pressing on the rib joints (costochondral joints) is a characteristic feature of costochondritis. Without tenderness, a diagnosis of costochondritis is unlikely.
  • Chest pain associated with costochondritis can be preceded or aggravated by exercises, minor injury, or an upper respiratory infection.
  • Costochondritis pain usually will be sharp and located on the front chest wall. It may radiate from the chest area to the back or abdomen to cause back pain or belly pain.
  • The most common sites of pain are the fourth, fifth, and sixth ribs. This pain increases when moving the trunk or when deep breathing and, therefore, may cause breathing problems. Conversely, it decreases as any movement stops or with quiet breathing.
    • Costochondritis can be misdiagnosed or accompanied by anxiety about having chest pain.
    • When costochondritis occurs as a result of infection after an operation (surgery), there can be inflammation with redness, swelling, or pus discharge at the site of the procedure.

Costochondritis Causes

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.

Costochondritis Symptoms, Causes, and Treatment Slideshow

Costochondritis Symptoms, Causes, and Treatment Slideshow

Costochondritis is an inflammation of the area where the ribs join the cartilage that is attached to the sternum. Costochondritis causes chest pain, especially upon palpation of the area. It is a benign condition that often resolves on its own without treatment. Chest pain from costochondritis must be differentiated from that of more serious conditions including heart attack, pericarditis, and other conditions. Costochondritis is a common cause of chest pain in children and adolescents.


Kasper, D.L., et al., eds. Harrison's Principles of Internal Medicine, 19th Ed. United States: McGraw-Hill Education, 2015.