Definition

Costochondritis is pain in the front of the chest wall. In particular, it is irritation where the bone and cartilage part of the ribs meet.

Sometimes there is also swelling and inflammation. This is a condition referred to as Tietze’s syndrome. Neither costochondritis nor Tietze’s syndrome is a serious disease. However, their symptoms are similar to those of several dangerous conditions, like a heart attack.

Causes

The cause of costochondritis is often not known. At other times, the condition can occur due to injury or overuse.

Risk Factors

Factors that may increase your chance of costochondritis include:

• Trauma to the chest
• Arthritis, especially:
  • Osteoarthritis
  • Rheumatoid arthritis
  • Ankylosing spondylitis
• Heavy lifting and strenuous exercise

Symptoms

Costochondritis may cause:

• Sharp, localized chest pain, which may be made worse by sneezing, coughing, deep breathing, or twisting motions of the chest
• Tenderness or swelling over a joint between:
  • Rib cartilage and breast bone
  • Rib cartilage and rib bone

Diagnosis

Your doctor will ask about your symptoms and medical history. A physical exam will be done. Your doctor may do further tests if the diagnosis is not clear. Tests to examine the ribs more closely may include a chest x-ray.

Treatment

Talk with your doctor about the best treatment plan for you. Most costochondritis will eventually go away on its own. Treatment is optional, but choices include the following:

Prevention

There are no current guidelines to prevent costochondritis.

Nemours Kids Health http://kidshealth.org

The College of Family Physicians of Canada http://www.cfpc.ca/ForPatients

Gilliland BC. Relapsing polychondritis and other arthritides. In: Isselbacher K, et al. Eds. Harrison’s Principles of Internal Medicine. 14th ed. New York, NY: McGraw-Hill; 1998:1055.

Proulx AM, Zryd TW. Costochondritis: Diagnosis and treatment. Am Fam Physician. 200915;80(6):617-620.