| Costochondritis | |
|---|---|
| Other names | Costosternal syndrome,[1] anterior chest wall syndrome,[1] costosternal chondrodynia,[2] parasternal chondrodynia[1] |
 | |
| The costal cartilages | |
| Specialty | Emergency medicine |
| Symptoms | Pain and tenderness at the costal cartilage[3] |
| Duration | Weeks to months[1] |
| Risk factors | Repetitive physical activities, preceding cough[3][1] |
| Diagnostic method | Based on symptoms after ruling out other causes[4][5] |
| Differential diagnosis | Heart attack, angina, heartburn, pneumonia, pulmonary embolism, shingles, Tietze's syndrome[4][1] |
| Treatment | NSAIDs, ice and heat, physiotherapy[5][1] |
| Prognosis | Good[5] |
| Frequency | ~25% of chest pain[1] |
Costochondritis is chest wall pain at the costal cartilage, the structure that connects each rib to the sternum.[5] The pain is generally localized and can be recreated by pushing on the area.[4] Multiple areas of cartilage may be involved.[1] Pain may be worsened with certain movements and taking a deep breath.[5] The quality of the pain may be sharp or dull.[5] Costochondritis typically resolves with time, though may recur.[5]
Risk factors include repetitive physical activities or a preceding cough.[3][1] Diagnosis involves ruling out other conditions that may present similarly including: heart attack, angina, heartburn, pneumonia, and pulmonary embolism.[5][4] Vital signs are generally normal.[5] The underlying mechanism is believed to involved inflammation.[1] If swelling is involved the condition is known as Tietze's syndrome, a term which maybe used interchangeably but is considered a separate disease.[1][6]
Chest pain is considered a medical emergency until life-threatening diseases are ruled out.[5] Treatment of costochondritis may include rest, ice and heat, paracetamol (acetaminophen), and nonsteroidal anti-inflammatory medication (NSAIDs).[1] Persistent cases may be managed with physiotherapy[5] or local steroid injections.[1] Costochondritis represents about 13 to 36%% of cases of chest pain.[4][1] Both children and adults may be affected.[1]
References edit
- ^ a b c d e f g h i j k l m n o p Proulx, AM; Zryd, TW (2009). "Costochondritis: diagnosis and treatment". American Family Physician. 80 (6): 617–620. PMID 19817327.
- ^ Mayo Clinic Staff (2012). "Costochondritis Definition". Mayo Clinic. Retrieved 26 December 2012.
- ^ a b c Stochkendahl, MJ; Christensen, HW (2010). "Chest pain in focal musculoskeletal disorders". The Medical Clinics of North America. 94 (2): 259–273. doi:10.1016/j.mcna.2010.01.007. PMID 20380955.
- ^ a b c d e McConaghy, JR; Oza, RS (1 February 2013). "Outpatient diagnosis of acute chest pain in adults". American family physician. 87 (3): 177–82. PMID 23418761.
- ^ a b c d e f g h i j k Schumann, JA; Sood, T; Parente, JJ (January 2020). "Costochondritis". PMID 30422526.
{{cite journal}}: Cite journal requires|journal=(help) - ^ Jindal, A; Singhi, S (2011). "Acute chest pain". Indian Journal of Pediatrics. 78 (10): 1262–1267. doi:10.1007/s12098-011-0413-1. PMID 21541647.