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Pain Management Health Center

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Costochondritis Overview

Costochondritis is an inflammation of the junctions where the upper ribs join with the cartilage that holds them to the breastbone, or sternum. The condition causes localized chest pain that you can reproduce by pushing on the cartilage in the front of your ribcage. Costochondritis is a relatively harmless condition and usually goes away without treatment. The cause is usually unknown, but may happen from increased activity involving the arms.


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  • Costochondritis (with unknown cause) is a common cause of chest pain in children and adolescents. It accounts for 10% to 30% of all chest pain in children. Annually, doctors evaluate about 650,000 cases of chest pain in young people ages 10 to 21. The peak age for the condition is ages 12-14.
  • Costochondritis is also considered as a possible diagnosis for adults who have chest pain. Chest pain in adults is considered a potentially serious sign of a heart problem by most doctors until proven otherwise. Chest pain in adults usually leads to a battery of tests to rule out heart attack and heart disease. If those tests are normal and your physical exam is consistent with costochondritis, your doctor will diagnose costochondritis as the cause of your chest pain. It is important, however, for adults with chest pain to be examined and tested for heart disease before being diagnosed with costochondritis. It is often difficult to distinguish between the two without further testing. The condition affects females more than males (70% versus 30%). Costochondritis may also occur as the result of an infection or as a complication of surgery on your sternum.
  • Tietze syndrome is often referred to as costochondritis, but the two are distinct conditions. You can tell the difference by noting the following:
    • Tietze syndrome usually comes on abruptly, with chest pain radiating to your arms or shoulder and lasting several weeks. Tietze syndrome is accompanied by a localized swelling at the painful area (the junction of the ribs and breastbone).

Costochondritis Causes

Costochondritis is an inflammatory process but usually has no definite cause. Repeated minor trauma to the chest wall, overuse of the arms, or viral respiratory infections can commonly cause chest pain due to costochondritis. Occasionally, costochondritis as a result of bacterial infections can occur in people who use IV drugs or who have had surgery to their upper chest. After surgery, the cartilage can become more prone to infection, because of reduced blood flow in the region that has been operated on.

Different types of infectious diseases can cause costochondritis.

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