Chest pain associated with costochondritis is usually preceded by exercise, minor trauma, or an upper respiratory infection.
- The pain usually will be sharp and located on your front chest wall. It may radiate to your back or abdomen and is more common on your left side.
- The most common sites of pain are your fourth, fifth, and sixth ribs. This pain increases as you move your trunk or take deep breaths. Conversely, it decreases as your movement stops or with quiet breathing.
- The reproducible tenderness you feel when you press on the rib joints (costochondral junctions) is a constant feature of costochondritis. Without this tenderness, a diagnosis of costochondritis is unlikely.
- Tietze syndrome, on the other hand, exhibits swellings at the rib-cartilage junction. Costochondritis has no noticeable swelling. Neither condition involves pus or abscess formation.
- Tietze syndrome usually affects the junctions at the second and third ribs. The swelling may last for several months. The syndrome can develop as a complication of surgery on your sternum months to years after the operation.
- When costochondritis occurs as a result of infection after surgery, you will see redness, swelling, or pus discharge at the site of the surgery.
When to Seek Medical Care
Call the doctor for any of the following symptoms:
- Trouble breathing
- High fever
- Signs of infection such as redness, pus, and increased swelling at the rib joints
- Continuing or worsening pain despite medication
Go to a hospital's emergency room if you have difficulty breathing or any of the following symptoms occur. These symptoms are generally not associated with costochondritis:
- High fever not responding to fever-reducers such as acetaminophen (Tylenol) or ibuprofen (Advil)
- Signs of infection at the tender spot, such as pus, redness, increased pain, and swelling
- Persistent chest pain of any type associated with nausea, sweating, left arm pain, or any generalized chest pain that is not well localized. These may be signs of a heart attack. If you are not sure what is causing your condition, always go to the emergency room.